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Saturday, March 3, 2001

Study determines trends in ACL treatment

A survey of orthopaedic sports medicine specialists to determine trends of anterior cruciate ligament reconstruction (ACLR) and rehabilitation found 70 percent of the specialists do not routinely attempt conservative treatment for ACL tears and 56 percent said ACLR is performed three to six weeks after injury. The survey of 855 members of the American Orthopaedic Society for Sports Medicine, presented in poster exhibit 6, found only 2 percent perform immediate ACLR less than 1 week post-injury.

Almost all respondents (94 percent) use bone-patella tendon-bone (BPTB). Most of the respondents (56 percent) use BPTB predominantly (>90 percent of ACLR). Hamstrings or allografts are used predominantly by fewer respondents, 9 percent and 1 percent, respectively. Graft fixation for BPTB is most commonly interference screws (87 percent). Hamstring graft fixation is most commonly the endobutton (30 percent) on the femur and combined fixation on the tibia.

Forty percent of the respondents perform only outpatient ACLR while 20 percent perform only inpatient ACLR. Immediate postoperative, full-weight bearing is permitted by 61 percent. The average time for return to unrestricted activity is not statistically different for BPTB, hamstring or allograft--6.4, 6.3, 6.8 months, respectively.

Several trends are noted as the respondents' ACLR per year increases. Time from injury to ACLR decreases (p=.007). Hamstring graft use increases (p=.002). Outpatient surgery increases (p=.001). The time to unrestricted activity statistically decreases for BPTB (p<.001), but not for hamstrings or allografts.

Coauthors of the study are Brian S. DeLay, MD; Robert J. Smolinski, MD; Robert J. Nicoletta, MD; and Daniel Bowman, BS, all of State University of New York at Buffalo, N.Y.

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2001 Academy News March 3 Index C

Last modified 15/February/2001 by IS