Non-operative management in sedentary older or in patients who wish to avoid surgery usually includes a detailed history of the condition, details of the current symptoms and disability, current and previous medications and past medical history. Clinical examination is undertaken by Mr. Johnson and subsequently radiographs or MRI scans can be arranged if necessary. An opinion is usually then available and discussed with the patient. Mr. Johnson will outline options for further treatment, and patients will then be encouraged to participate in the decisions about which treatment options are most appropriate.
In many patients the outcome of non-operative treatment can be expected to be unsatisfactory . This may be in cases where there has been instability since the time of
injury or alternately patients have experienced chronic instability, demonstrable excessive laxity, concomitant meniscal injury, chondral injury or degenerative change. Then the surgical option may be most appropriate. Also in elite or competitive athletes surgical reconstruction can be undertaken at an early date soon after the injury as few patients can undertake competitive sports at the same level after such an injury particularly where the sport involve twisting or pivoting activities.
Initial non-operative management may include physiotherapy, use of anti-inflammatory medication (Ibruprofen, diclofenac, vioxx etc), and use of an ACL knee brace. If non-operative management proves unsatisfactory with an inability of the patient to return to their desired activity or further instability occurs then the surgical option can always be revisited.