Table 3.

Consensus statements on non-operative and operative treatments of ACL injury

	Agreed statements	Agreement (%)
1	Operative and non-operative treatments are both acceptable treatment options for ACL injury	100
2	Operative versus non-operative treatments should be reached via a shared decision-making process that considers the patient’s presentation, goals, and expectations as well as a balanced presentation of the available evidence-based literature	82.6
3	The (injury) status of other stabilizing and supporting structures (e.g. meniscus, other ligaments, and cartilage) affects the decision to pursue operative or non-operative treatment	100
4	Individual anatomical differences (e.g., tibial slope, femoral morphology, alignment, etc.) may affect the stability of the knee after ACL injury and should be considered in the decision-making process for operative versus non-operative treatments	95.7
5	After an ACL injury, patients may be offered a period of progressive rehabilitation to improve impairments and improve overall function	100
6	An individual presenting with instability in their desired activity despite optimal rehabilitation should be referred for operative treatment	100
7	Development of osteoarthritis after an ACL injury is multifactorial and evidence is inconclusive following operative or non-operative treatments	100
8	In active patients wishing to return to jumping, cutting, and pivoting sports (e.g., soccer, football, handball, basketball): Operative treatment is the preferred option to maintain athletic participation in the medium-to-long term (1 to 5 + years after injury)	100
9	In active patients wishing to return to jumping, cutting, and pivoting sports (e.g., soccer, football, handball, basketball): Return to cutting and pivoting sports without surgery places the knee at risk of secondary injury (meniscus, cartilage, etc.)	100
11	In active patients wishing to return to straight plane activities (e.g., running, cycling, swimming, weight-lifting, etc.): Non-operative treatment is an option	100
12	In active patients wishing to return to straight plane activities (e.g., running, cycling, swimming, weight-lifting, etc.): In the case of persistent instability in daily life, operative treatment is appropriate for a return to non-rotational activities	100
	Not agreed statement
10	In active patients wishing to return to cutting and pivoting sports (e.g., soccer, football, handball, basketball): Delayed operative treatment may be an option for temporary return to athletic participation following non-operative treatment accepting the risk of additional injury	43.4