A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears

This landmark randomized controlled trial compared two strategies for young, active adults with an acute anterior cruciate ligament (ACL) tear: structured rehabilitation plus early ACL reconstruction versus structured rehabilitation with the option of later reconstruction if needed. Involving 121 patients followed for two years, the primary outcome was change in the Knee Injury and Osteoarthritis Outcome Score (KOOS4). The trial found that early surgical reconstruction was not superior to a strategy of optional delayed reconstruction, and the latter approach substantially reduced the number of surgeries performed, reshaping clinical guidance on ACL tear management in young athletes.