In 2006, in a survey regarding anterior cruciate ligament (ACL) reconstruction mailed to physician members of the American Orthopaedic Society for Sports Medicine, a total of nearly 1000 responses were received from 1747 possible respondents (57%).
The number of ACL reconstructions per year ranged from 1 to 275 (mean=55).
Our own experience is slowly growing with mean 30 caseload per year for the last decade.
The most important factors in the timing of surgery were (?) knee range of motion and effusion.
Bone-patellar tendon-bone (BPTB) autograft was most commonly preferred (46%), followed by hamstring tendon autograft (32%) and allografts (22%).
Five years earlier, BPTB grafts are more frequent and hamstring tendon and allografts, less frequent (63%, 25%, and 12%, respectively).
A single-incision arthroscopic technique is used by 90%.
Most allowed return to full activity at 5 to 6 months, with a trend toward earlier return for BPTB grafts; quadriceps strength was an important factor in the decision (?).
There is limited experience (4%) with double-bundle and computer-assisted ACL reconstruction.
Arthroscopic-assisted (?), single-incision reconstruction using a BPTB autograft fixed with metal (?) interference screws remains the most common technique used for primary ACL reconstruction.
In the past 5 years, the use of alternative graft sources and methods of fixation has increased.
Consensus regarding the best
- graft type,
- fixation method, and
- postoperative protocol
is still lacking.
