This review summarizes the clinical contributions of the MOON consortium — a prospective cohort of more than 4,400 ACL reconstructions across seven institutions. It describes how the group's 40+ publications changed ACL reconstruction practice, rehabilitation protocols, and the model for multicenter orthopaedic outcomes research.
Two findings from MOON should directly change how you counsel patients before ACL reconstruction. First, for any patient under 20, autograft is non-negotiable: allograft fails 4 times more often, and failure odds compound 2.3-fold with each decade younger. When a high school athlete or their parent asks about allograft to avoid donor-site morbidity, this is your answer.
Second, the bilateral injury risk is underappreciated: at 6 years, contralateral ACL tear (6.4%) and ipsilateral graft rupture (7.7%) occur at nearly the same rate. Every post-ACLR patient needs to hear that the other knee is almost as vulnerable as the reconstructed one.
On the rehabilitation side, MOON's evidence review is equally practice-changing: skip the CPM machine (no benefit, added cost), skip the brace (no advantage over no bracing), and start early weight bearing and closed-chain exercises in the first 6 weeks.
This review summarizes the clinical contributions of the MOON consortium — a prospective cohort of more than 4,400 ACL reconstructions across seven institutions. It describes how the group's 40+ publications changed ACL reconstruction practice, rehabilitation protocols, and the model for multicenter orthopaedic outcomes research.
Two findings from MOON should directly change how you counsel patients before ACL reconstruction. First, for any patient under 20, autograft is non-negotiable: allograft fails 4 times more often, and failure odds compound 2.3-fold with each decade younger. When a high school athlete or their parent asks about allograft to avoid donor-site morbidity, this is your answer.
Second, the bilateral injury risk is underappreciated: at 6 years, contralateral ACL tear (6.4%) and ipsilateral graft rupture (7.7%) occur at nearly the same rate. Every post-ACLR patient needs to hear that the other knee is almost as vulnerable as the reconstructed one.
On the rehabilitation side, MOON's evidence review is equally practice-changing: skip the CPM machine (no benefit, added cost), skip the brace (no advantage over no bracing), and start early weight bearing and closed-chain exercises in the first 6 weeks.