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Frobell and colleagues' NEJM paper debunks ‘early reconstruction’ after ACL rupture: give a piece of rehab a chance!
  1. Karim M Khan
  1. Correspondence to Dr Karim M Khan, The University of British Columbia, UBC, Centre for Hip Health and Mobility, Suite 320-5950 University Boulevard, Vancouver V6T 1Z3, Canada; karim.khan{at}

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A hot Saturday in Vancouver (that's news!). Warm up deadline imminent, but the draft is turgid. Check email (ie, procrastinate). Subject line: ‘Did you see New England Journal of Medicine (NEJM) anterior cruciate ligament (ACL) paper?’ I click through and see that Dr Richard Frobell et al1 from Sweden and Denmark asked whether structured rehabilitation could match early ACL reconstruction! In the spirit of Inglourious Basterds2 I say to myself ‘Now that's a bingo!’..Open a new Microsoft Word document. ‘A hot Saturday in Vancouver..’

Experts said this study could not be done. This paper is an absolute ‘game changer’ given that ACL surgery costs exceed $5000 per patient in the USA.3 The Holy Grail of research is ‘impact,’ and this team's research will influence management of well over a million people worldwide who rupture their ACL annually. Adding further weight to their study is the public health significance of almost universal post-ACL injury osteoarthritis.4 Therefore, this Warm up underscores the critical nature of the paper, highlights the authors' podcasts ( and …

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