The ACL SNNAP Trial: ACL Surgery Necessity in Non Acute Patients.
Research type
Research Study
Full title
The ACL SNNAP Trial: ACL Surgery Necessity in Non Acute Patients. Comparison of the clinical and cost effectiveness of two management strategies for non-acute Anterior Cruciate Ligament (ACL) injury: Rehabilitation versus surgical Reconstruction.
IRAS ID
199315
Contact name
David Beard
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
3 years, 7 months, 30 days
Research summary
The primary objective of this multicentre Randomised Controlled Trial is to determine in patients with non-acute (greater than 4 months since injury) Anterior Cruciate Ligament Deficiency (ACLD) whether a strategy of non-surgical management [physiotherapy rehabilitation with option for later ACL reconstruction only if required) is more clinically effective and cost effective than a strategy of surgical management [reconstruction]. Undergoing structured rehabilitation first may prevent the need for surgery. This was observed in a Scandinavian study, where ACL injury treatment is given more immediately following injury (when injury is acute) unlike in the UK where treatment generally commences after a few months following injury (injury is non-acute). If it is found that rehabilitation treatment of non-acute ACL injuries is successful, it will mean that patients may not need to undergo surgery. The treatments provided in this study will be the standard operative or non-operative treatment currently provided in the UK. Having surgery includes NHS waiting times, potential operative and anaesthetic risks and is a more expensive treatment option. Both treatment groups will be monitored to make sure the treatment allocated to them is appropriate. However, if rehabilitation is unsuccessful, patients with continued instability may still require surgery. Furthermore the participant will be required to complete a baseline questionnaire and three follow-up questionnaires at six, twelve and eighteen months.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
16/SC/0502
Date of REC Opinion
12 Oct 2016
REC opinion
Favourable Opinion