How Can We Identify Copers?

Abstract

Anterior cruciate ligament (ACL) reconstruction is common after ACL injury, particularly in young, active individuals. However, after ACL reconstruction not all athletes will return to sport and these individuals are at a high risk for a second ACL injury and osteoarthritis. This chapter will discuss the screening algorithms available to evaluate athletes shortly after ACL injury and help determine who are good candidates to pursue nonoperative management and return to sport. Further, research has shown that with extended physical therapy following an ACL injury, many athletes can return to their prior level of sports without ACL reconstruction. With recent evidence that outcomes after operative and nonoperative ACL injury management do not necessarily favor surgery, the authors recommend that athletes undergo physical therapy and screening following ACL injury in order to determine if they may be a candidate for nonoperative management, as the decision to pursue nonoperative management is reversible, but ACL reconstruction is final.