Comparative Study of Conservative versus Surgical Management of Anterior Cruciate Ligament Injuries in Young Population in the Indian Scenario

Abstract

Background: Anterior cruciate ligament (ACL) injuries are among the most common ligamentous injuries of the kneejoint, particularly in young, active individuals involved in sports such as football, kabaddi, and athletics. Managementstrategies vary between conservative rehabilitation and surgical reconstruction. In the Indian context, socioeconomic,infrastructural, and rehabilitative disparities influence treatment decisions. Objective: To compare the outcomes of conservative versus surgical management of ACL injuries in the young Indianpopulation and assess which modality ensures better return to function and sport. Methods: A literature-based comparative analysis was conducted using recent Indian and international studies, includingrandomized controlled trials and cohort analyses. Outcome measures compared included functional scores (IKDC,Lysholm), knee stability, return-to-sport rate, and complications. Results: Evidence suggests that in selected young patients, structured rehabilitation alone may yield outcomes comparableto early reconstruction in terms of knee function and long-term osteoarthritis risk. However, in highly active individualsor competitive athletes, surgical reconstruction provides superior mechanical stability and higher rates of return to sport. Indian cohort studies reveal high success rates with ACL reconstruction, especially when coupled with lateral extraarticular tenodesis (LET). Conclusion: In the Indian scenario, the choice between conservative and surgical management should be individualized. While both methods can provide satisfactory outcomes, surgical management is favored for high-demand athletes andcases of recurrent instability. Adequate rehabilitation infrastructure and patient compliance are essential determinantsof success in either approach.