This study really caught my attention: Long-term Outcome After Nonoperative Treatment for Rockwood I and II Acromioclavicular Joint Injuries published in the American Journal of Sports Medicine. You don´t see this kind of studies every day in sports surgery journals. Actually I managed to find only 20 studies ever published in the AJSM which mentioned “nonoperative” in the title.
Common soft tissue conditions such as ACL injury, Achilles tendon ruptures, rotator cuff tears, proximal hamstring injuries and grade III-IV AC-ligament injuries can be treated successfully without surgery. The older the patient, the more likely the nonoperative treatment will succeed. Research on nonoperative treatment in common soft tissue injuries is, however, just too scarce. Eventually it´s all about our patients´ best. With successful nonoperative treatment devastating surgical complications may be totally avoided.
Steven McPhail writes:
Some surgeons’ resistance to de-implementation of surgical interventions like APM may be, at least in part, due to the nature of clinical training and surgeons’ perceptions of favourable outcomes among their own patients, as well as professional renown or financial gain in healthcare systems that value and reward surgical activity rather than patient outcomes.
Although surgical treatment of those common soft tissue injuries cannot be considered low-value, as APM, the very same reasons outlined by McPhail explains why surgeons are not that interested in nonoperative treatment.