SRS30 - Exploring the efficacy of conservative management <i>versus</i> surgical intervention in Anterior Cruciate Ligament (ACL) injuries: insights into reinjury rates, quality of life, and long-term outcomes

Abstract This systematic review and meta-analysis evaluate the comparative outcomes of conservative management versus surgical intervention for anterior cruciate ligament (ACL) injuries. A comprehensive search of PubMed, Cochrane Library, Web of Science, SPORTDiscus, and Google Scholar focused on studies published between 2010 and 2024. Data synthesis employed both thematic analysis for qualitative data and meta-analysis for quantitative outcomes. Key findings indicate that conservative management yields lower reinjury rates and higher quality of life (QoL) scores (64.6 versus 57.1) compared to surgical intervention, though differences were not statistically significant (P = 0.1483). Both strategies demonstrated comparable return-to-sport (RTS) rates. Meta-regression analysis revealed that longer follow-up durations positively influenced outcomes (P = 0.0288). The average complication rate was 49.83 per study (c.i.: 25.84–73.82), underscoring significant risks associated with both approaches. Conservative management shows promise as an initial treatment option for certain ACL injuries, particularly regarding reinjury prevention and QoL improvements. However, surgical intervention remains crucial for specific cases requiring enhanced knee stability. The results underscore the importance of individualized treatment planning, long-term follow-up, and further standardization of outcome measures in future research.