Table 2

Consensus statements on non-operative and operative treatment of ACL injury

Agreed statementsAgreement
1Operative and non-operative treatments are both acceptable treatment options for ACL injury.100%
2Operative versus non-operative treatment should be reached via a shared decision-making process that considers the patient’s presentation, goals and expectations as well as a balanced presentation of the available evidence-based literature.82.6%
3The (injury) status of other stabilising and supporting structures (eg, meniscus, other ligaments, cartilage) affects the decision to pursue operative or non-operative treatment.100%
4Individual anatomical differences (eg, tibial slope, femoral morphology, alignment, etc) may affect the stability of the knee after ACL injury and should be considered in the decision-making process for operative versus non-operative treatment.95.7%
5After an ACL injury, patients may be offered a period of progressive rehabilitation to improve impairments and improve overall function.100%
6An individual presenting with instability in their desired activity despite optimal rehabilitation should be referred for operative treatment.100%
7Development of osteoarthritis after an ACL injury is multifactorial and evidence is inconclusive following operative or non-operative treatment.100%
8In active patients wishing to return to jumping, cutting and pivoting sports (eg, soccer, football, handball, basketball): Operative treatment is the preferred option to maintain athletic participation in the medium to long term (1 to 5+ years after injury).100%
9In active patients wishing to return to jumping, cutting and pivoting sports (eg, soccer, football, handball, basketball): Return to cutting and pivoting sports without surgery places the knee at risk of secondary injury (meniscus, cartilage, etc).100%
11In active patients wishing to return to straight plane activities (eg, running, cycling, swimming, weightlifting, etc): Non-operative treatment is an option.100%
12In active patients wishing to return to straight plane activities (eg, running, cycling, swimming, weight-lifting, etc): In the case of persistent instability in daily life, operative treatment is appropriate for a return to non-rotational activities.100%
Not agreed statement
10In active patients wishing to return to cutting and pivoting sports (eg, soccer, football, handball, basketball): Delayed operative treatment may be an option for temporary return to athletic participation following non-operative treatment accepting the risk of additional injury.43.4%