Assessment of functional recovery in patients with ACL injuries managed conservatively versus surgically: A comparative observational study.

Authors

  • Dr . Venkatesh Karri Assistant Professor, Department of Orthopaedics, Jawaharlal Nehru Medical College, Sawangi, Meghe, Wardha, Maharashtra, India
  • Dr.Rajendar Adicharla Consultant Orthopaedic Surgeon, Sri Sharanya Nursing Home, Warangal, Telangana, India
  • Dr. Sravankumar Kamarapu Assistant Professor Department of Orthopaedics, Government Medical College and General Hospital, Asifabad, Telangana, India
  • Dr. Geetha Sindhuja Boddeda Senior Resident, Department of Anaesthesiology, Jawaharlal Nehru Medical College, Sawangi,Meghe, Wardha, Maharashtra, India
  • Dr. Dubasi Vydehi Consultant Ophthalmology, Mallikarjuna Laser Eye & Skin Care Hospital , Warangal, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2077

Keywords:

Anterior cruciate ligament, functional outcome, conservative management, surgical reconstruction, International Knee Documentation Committee Lysholm score

Abstract

Background: Anterior cruciate ligament injury is a leading cause of knee instability that compromises physical activity and quality of life. Although surgical reconstruction remains the gold standard for restoring knee stability in young and active individuals, conservative treatment continues to be employed in patients with lower activity levels or surgical contraindications. This study evaluated functional outcomes, return to activity, instability, and complications among ACL-injured patients managed conservatively or surgically.

 Methods: A comparative observational study was conducted on 100 patients with ACL injuries, divided equally into conservative (n = 50) and surgical (n = 50) groups. Baseline demographics, injury characteristics, and management details were recorded. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) and Lysholm scores at baseline, six months, and 11 months. Return to pre-injury activity, instability episodes, and complications were analyzed. Statistical tests included Student’s t-test and Chi-square, with p < 0.05 considered significant.

 Results: Baseline characteristics, including mean age (27.6 ± 5.4 vs. 26.9 ± 6.1 years) and gender distribution, were comparable between groups (p > 0.05). At 11 months, surgically managed patients demonstrated significantly higher IKDC (85.1 ± 7.6 vs. 70.4 ± 8.2) and Lysholm scores (88.6 ± 6.9 vs. 74.3 ± 8.4) (p < 0.001 for both). Return to pre-injury sports was achieved in 62% of surgical versus 34% of conservative cases (p = 0.01). Instability episodes were more frequent with conservative care (28% vs. 10%, p = 0.02). Minor complications included donor-site pain (10%) and superficial infection (4%) in the surgical group.

 Conclusion: Surgical reconstruction of ACL injuries yielded superior functional outcomes, greater return-to-sport rates, and fewer instability episodes compared with conservative management. Conservative treatment remains reasonable for patients with limited functional demands.

 Recommendations: Multicentric studies with larger cohorts and extended follow-up are warranted to strengthen evidence and refine individualized treatment strategies.

Author Biographies

Dr . Venkatesh Karri , Assistant Professor, Department of Orthopaedics, Jawaharlal Nehru Medical College, Sawangi, Meghe, Wardha, Maharashtra, India

is an Assistant Professor in the Department of Orthopaedics at Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India. He obtained his MBBS degree in 2008 from Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Chinaoutapally, Andhra Pradesh, and completed his postgraduate training in Orthopaedics in 2016 at Konaseema Institute of Medical Sciences & Research Foundation (KIMS & RF), Amalapuram, Andhra Pradesh.

Dr. Karri has over six years of academic and clinical experience. He has worked as a Senior Resident at KIMS & RF, Amalapuram, followed by faculty appointments as Assistant Professor in Orthopaedics at Mamatha Medical College, Khammam (June 2022 – September 2023), and currently at JNMC, Wardha (since August 2024). Additionally, he has served as a Consultant Orthopaedic Surgeon in private hospitals for three years, where he gained extensive experience in trauma management, arthroplasty, and musculoskeletal disorders. He is actively involved in medical education, clinical research, and patient-centered orthopaedic care. ORCID ID: https://orcid.org/0009-0008-8760-7126

Dr.Rajendar Adicharla , Consultant Orthopaedic Surgeon, Sri Sharanya Nursing Home, Warangal, Telangana, India

is a Consultant Orthopaedic Surgeon currently practicing at Sri Sharanya Nursing Home, Warangal, Telangana, India. He completed his MBBS from Mamata Medical College, Khammam, followed by a Diploma in Orthopaedics from Prathima Institute of Medical Sciences, Karimnagar. He further pursued DNB Orthopaedics at BIRRD Hospital, Tirupati.

Dr. Adicharla has extensive clinical experience, having served as a Registrar at Lalitha Hospital, Warangal (2019–2020), Consultant Orthopaedic Surgeon at Sunshine Hospitals, Karimnagar (2023–2024), and Senior Resident in the Department of Orthopaedics at Chalmeda Anandrao Institute of Medical Sciences, Karimnagar (2024–2025). His areas of expertise include trauma surgery, joint reconstruction, arthroscopy, and musculoskeletal disorders. With a strong commitment to patient-centered care and evidence-based practice, he continues to contribute actively to orthopaedic clinical services and academic development. ORCID ID: https://orcid.org/0009-0003-1672-5583

Dr. Sravankumar Kamarapu , Assistant Professor Department of Orthopaedics, Government Medical College and General Hospital, Asifabad, Telangana, India

is a Consultant Orthopaedic Surgeon and currently serves as an Assistant Professor in the Department of Orthopaedics at Government Medical College, Asifabad, Telangana, India. He completed his MBBS from Chalmeda Anandrao Institute of Medical Sciences, Karimnagar, and obtained his MS in Orthopaedics from Prathima Institute of Medical Sciences, Karimnagar.

He has previously worked as a Senior Resident at Government Medical College, Siddipet, and at Chalmeda Anandrao Institute of Medical Sciences, Karimnagar. He also served as an Assistant Professor at Chalmeda Anandrao Institute of Medical Sciences before joining his current position. His areas of clinical expertise include trauma management, joint reconstruction, arthroscopy, and musculoskeletal disorders. He remains actively engaged in orthopaedic teaching, patient care, and academic development. ORCID ID: https://orcid.org/0009-0001-9162-4868

Dr. Geetha Sindhuja Boddeda , Senior Resident, Department of Anaesthesiology, Jawaharlal Nehru Medical College, Sawangi,Meghe, Wardha, Maharashtra, India

is a Senior Resident in the Department of Anaesthesiology at Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India. She completed her MBBS in 2013 from Konaseema Institute of Medical Sciences & Research Foundation (KIMS & RF), Amalapuram, Andhra Pradesh, and obtained her postgraduate degree in Anaesthesiology in 2021 from Jawaharlal Nehru Medical College, Wardha, Maharashtra.

With six months of experience as a Senior Resident, Dr. Boddeda is actively involved in perioperative patient care, trauma and critical care management, academic teaching, and clinical research. Her professional interests include airway management, regional anaesthesia techniques, perioperative pain management, and advancements in evidence-based anaesthesiology. ORCID ID: https://orcid.org/0009-0008-6668-2602

Dr. Dubasi Vydehi , Consultant Ophthalmology, Mallikarjuna Laser Eye & Skin Care Hospital , Warangal, Telangana, India

Consultant Ophthalmologist, Mallikarjuna Laser Eye & Skin Care Hospital, Warangal, Telangana, India. She completed her MBBS in 2015 from Gandhi Medical College, Secunderabad, and obtained her Diploma in Ophthalmology (D.O.) from Osmania Medical College, Hyderabad, in 2022. She served as a Senior Resident in the Department of Ophthalmology at Government General Hospital, Mancherial, from 2022 to 2023. She is presently working as a Consultant Ophthalmologist at Mallikarjuna Laser Eye & Skin Care Hospital, Warangal. Her professional interests include comprehensive ophthalmic care with a focus on anterior segment disorders, cataract management, and community eye health.

References

Krause M, Freudenthaler F, Frosch KH, Achtnich A, Petersen W, Akoto R. Operative Versus Conservative Treatment of Anterior Cruciate Ligament Rupture. Dtsch Ärztebl Int. 2018 Dec 24;115(51-52):855-862. doi: 10.3238/arztebl.2018.0855. PMID: 30765021; PMCID: PMC6381773. https://doi.org/10.3238/arztebl.2018.0855

Papaleontiou A, Poupard AM, Mahajan UD, Tsantanis P. Conservative vs Surgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review. Cureus. 2024 Mar 20;16(3):e56532. doi: 10.7759/cureus 56532. PMID: 38646275; PMCID: PMC11027445. https://doi.org/10.7759/cureus.56532

He Y, Fan Y, Zhai L, Zhu W. Comparative efficacy and safety of different surgical approaches for the treatment of anterior cruciate ligament injury: a Bayesian network meta-analysis protocol. BMJ Open. 2024 Mar 29;14(3):e077242. doi: 10.1136/bmjopen-2023-077242. PMID: 38553073; PMCID: PMC10982744. https://doi.org/10.1136/bmjopen-2023-077242

Onobun DE, Orji C, Ojo EO, Adebisi AA, Igbokwe K, Sehmar R, et al. Exploring the Efficacy of Conservative Management Versus Surgical Intervention in Anterior Cruciate Ligament (ACL) Injuries: Insights Into Reinjury Rates, Quality of Life, and Long-Term Outcomes. Cureus. 2024 Nov 29;16(11):e74718. doi: 10.7759/cureus 74718. PMID: 39734976; PMCID: PMC11682532. https://doi.org/10.7759/cureus.74718

Diermeier T, Rothrauff BB, Engebretsen L, Lynch AD, Ayeni OR, Paterno MV,et al. Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group. Orthop J Sports Med. 2020 Jun 24;8(6):2325967120931097. Doi: 10.1177/2325967120931097. PMID: 32637434; PMCID: PMC7315684. https://doi.org/10.1177/2325967120931097

Greenberg EM, Greenberg ET, Ganley TJ, Lawrence JT. Strength and functional performance recovery after anterior cruciate ligament reconstruction in preadolescent athletes. Sports Health. 2014 Jul;6(4):309-12. Doi: 10.1177/1941738114537594. PMID: 24982702; PMCID: PMC4065563. https://doi.org/10.1177/1941738114537594

Filbay SR, Grindem H. Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture. Best Pract Res Clin Rheumatol. 2019 Feb;33(1):33-47. doi: 10.1016/j.berh.2019.01.018. Epub 2019 Feb 21. PMID: 31431274; PMCID: PMC6723618. https://doi.org/10.1016/j.berh.2019.01.018

Evans J, Mabrouk A, Nielson JL. Anterior Cruciate Ligament Knee Injury. [Updated 2023 Nov 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499848/

de Jonge R, Máté M, Kovács N, Imrei M, Pap K, Agócs G, et al. Nonoperative Treatment as an Option for Isolated Anterior Cruciate Ligament Injury: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2024 Apr 8;12(4):23259671241239665. Doi: 10.1177/23259671241239665. PMID: 38601190; PMCID: PMC11005505. https://doi.org/10.1177/23259671241239665

Kumar H, Chawla HKS, Seth A, Mehta K, Sahni G, Sharma M, et al. Comparison of Surgical and Non-Surgical Treatment of Anterior Cruciate Ligament Injury in Middle-Aged Population: A Prospective Cohort Study. Cureus. 2025 May 20;17(5):e84489. doi: 10.7759/cureus 84489. PMID: 40539191; PMCID: PMC12178572. https://doi.org/10.7759/cureus.84489

Blanke F, Trinnes K, Oehler N, Prall WC, Lutter C, Tischer T, et al. Spontaneous healing of acute ACL ruptures: rate, prognostic factors, and short-term outcome. Arch Orthop Trauma Surg. 2023 Jul;143(7):4291-4298. Doi: 10.1007/s00402-022-04701-0. Epub 2022 Dec 14. PMID: 36515708; PMCID: PMC10293391. https://doi.org/10.1007/s00402-022-04701-0

Komnos GA, Hantes MH, Kalifis G, Gkekas NK, Hante A, Menetrey J. Anterior Cruciate Ligament Tear: Individualized Indications for Non-Operative Management. Journal of Clinical Medicine. 2024; 13(20):6233. https://doi.org/10.3390/jcm13206233

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Published

2025-09-11

How to Cite

Karri , D. . V. ., Adicharla , D. ., Dr. Sravankumar Kamarapu, Boddeda , D. G. S. ., & Dr. Dubasi Vydehi. (2025). Assessment of functional recovery in patients with ACL injuries managed conservatively versus surgically: A comparative observational study. Student’s Journal of Health Research Africa, 6(9), 9. https://doi.org/10.51168/sjhrafrica.v6i9.2077

Issue

Vol. 6 No. 9 (2025): September 2025 issue

Section

Section of Orthopedics

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Copyright (c) 2025 Dr Venkatesh Karri , Dr.Rajendar Adicharla , Dr. Sravankumar Kamarapu , Dr. Geetha Sindhuja Boddeda , Dr. Dubasi Vydehi

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