2025 ISAKOS Biennial Congress Paper
Multinational Trends in ACL Reconstruction Preferences over the Past 25 Years: Results from the Biennial ACL Study Group Survey 1998–2023
Ian Hollyer, MD, Stanford, CA UNITED STATES
Connor Sholtis, MD, Redwood Cty, CA UNITED STATES
Stewart Bryant, MD, Palo Alto, CA UNITED STATES
Yazdan Raji, MD, Chicago, IL UNITED STATES
Muzammil Akhtar, BS, Stanford, CA UNITED STATES
Nicholas Kwon, MD, Stanford, CA UNITED STATES
Christopher C. Kaeding, MD, Columbus, OH UNITED STATES
Tim Spalding, FRCS(Orth), Leamington Spa, Warwickshire UNITED KINGDOM
Ryosuke Kuroda, MD, PhD, Kobe, Hyogo JAPAN
Seth L. Sherman, MD, Redwood City, California UNITED STATES
Stanford University, Stanford, CA, UNITED STATES
FDA Status Not Applicable
Summary
This study examines global trends in the management of ACL injuries by analyzing the opinions and preferences of the ACL Study Group from the past 25 years of survey data.
Abstract
Purpose
To survey The ACL study group members to determine the current practice patterns surrounding anterior cruciate ligament reconstruction (ACLR) preferences and to analyze response trends over the past 25 years.
Methods
From 1998 to 2023, a web-based questionnaire was distributed to members of the ACL Study Group every two years. The questions explored ACLR topics related to graft preference, surgical technique, repair vs. reconstruction, meniscal repair, return to sport and postoperative care, and osteoarthritis risk.
Results
Analysis of the ACL Study Group's survey responses highlights a trend towards increased usage of single-bundle technique, hamstring autografts for primary ACLR, bone-patella-bone for revision ACLR, femoral fixation using cortical suspensory techniques, AM portal drilling for femoral tunnels, and declining use of allograft tissue in primary ACLR. Additionally, we observed a slight increase in primary ACL repair, aggressiveness for meniscal repair, and a move towards longer return-to-sport timelines.
Conclusion
Here, we present the opinions and preferences of the ACL Study Group over the past 25 years, which reflect emerging scientific evidence and changes in technology. These findings stimulate ongoing discussions regarding ACL injury management from a global perspective.