Survey Study of Members of the Canadian Orthopaedic Association on the Natural History and Treatment of Anterior Cruciate Ligament Injury

Objective: To describe current preferences and opinions of mem- bers of the Canadian Orthopaedic Association (COA) pertaining to anterior cruciate ligament (ACL) reconstruction.

Design: Survey study.
Participants: All orthopedic surgeon members of the COA residing in Canada were invited to participate.

Main Outcome Measures: The primary measure was a survey completed via an Internet-based survey manager. It was composed of 30 questions on the natural history of ACL-injured knees, and sur- gical and postsurgical treatment choices.

Results: Two hundred eighty-three surgeons (50%) responded to the survey. One hundred forty-four performed ACL reconstruction in the past year. In terms of natural history, the only area of agreement was that hamstring and quadricep strength affects function in ACL- deficient knees (92%). A majority of surgeons indicated preference for hamstring autograft (73%), transtibial versus anteromedial portal for establishment of the femoral tunnel (70% vs 28%), and promotion of full weight bearing and range of motion immediately after surgery (72% and 75%, respectively). The most frequent surgeon-reported complication was tunnel widening (10%). A greater proportion of high-volume surgeons permitted earlier return to sport (P , 0.008).

Conclusions: In the rapidly evolving area of ACL reconstruction, no recent surveys of opinions and preferences of Canadian orthopedic surgeons have been published. In addition to providing information from a Canadian perspective, the findings from this study will allow surgeons to evaluate a range of treatment decisions based on the general opinions of their colleagues and also highlight areas of dissimilarity that can be targeted for more extensive research.

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