The most severe forms of injuries to the knee often do not properly heal without surgical intervention. This is true whenever any major ligament is completely cut across or avulsed from its attachment, and particularly when the torn ends of one structure come to lie in positions that hinder the union of other structures. Surgical experience with over 150 cases of injury to the knee has shown that conservative treatment can be expected to lead to healing only when tears are partial. When the symptoms of pain, instability, abnormal mobility, hemarthrosis, and circumarticular effusions testify to severe injury, conservative treatment fails. The best results in such cases have been obtained when diagnosis was precise and surgical treatment prompt. Surgery is followed, on the same day, by physical therapy, which includes muscle-setting exercises (isometric contraction without joint motion) and other graded activities. A policy of complete repair and conscientious rehabilitation has given increasingly gratifying results.
O'Donoghue DH. SURGICAL TREATMENT OF INJURIES TO LIGAMENTS OF THE KNEE. JAMA. 1959;169(13):1423–1431. doi:10.1001/jama.1959.03000300019005
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