Summary: An exploration of patients’ and surgeons’ priorities related to anterior cruciate ligament reconstructions, and the magnitude of treatment effects in evidence that may influence surgical practice change.

Background

The priorities of patients should be shared by those treating them. Patients and surgeons are likely to have different priorities surrounding anterior cruciate ligament reconstruction (ACLR), with implications for shared decision-making and patient education. The optimal surgical approach for ACLR is constantly evolving, and the magnitude of treatment effect necessary for evidence to change surgical practice is unknown.

Purpose

The aim of this study was to determine 1) the priorities of surgeons and patients when making decisions regarding ACLR and 2) the magnitude of reduction in ACLR graft failure risk that orthopaedic surgeons require before changing practice.

Methods

This study followed a cross-sectional survey design. Three distinct electronic surveys were administered to pre-operative ACLR patients, post-operative ACLR patients, and orthopaedic surgeons in the ACL Study Group. Patients and surgeons were asked about the importance of various outcomes and considerations pertaining to ACLR. Surgeons were asked scenario-based questions regarding changing practice for ACLR based on new research.

Results

Surgeons were more likely to prioritize outcomes related to the surgical knee itself, whereas patients were more likely to prioritize outcomes related to their daily lifestyle and activities. Knee instability and risk of re-injury were unanimous top priorities among all three groups. A mean relative risk reduction in ACLR graft failure of about 50% was required by orthopaedic surgeons to change practice regardless of the type of change, or patient risk profile.

Conclusion

There are discrepancies between the priorities of surgeons and patients, and orthopaedic surgeons appear resistant to changing practice for ACLR.

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Quadriceps Tendon Autograft Has Lower MRI Signal Than Hamstring Tendon Autograft In Anterior Cruciate Ligament Reconstructions Of Adolescent Athletes Abstract Presentation 5 minutes David Alcoloumbre, MD, UNITED STATES Alexandra Hunter Aitchison, UNITED STATES Douglas Mintz, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES
PROSPECTIVE RANDOMIZED STUDY: Double-bundle against single-bundle ACL reconstruction using allografts Abstract Presentation 5 minutes Edmundo Berumen Nafarrate, PhD, Prof., MEXICO Carlos Alejandro Vega Najera, MD, MEXICO Joel Alejandro Cabral, MD, MEXICO Jesus Javier Tonche, MD, MEXICO Ivan Ramos Moctezuma, Eng, MEXICO Luis Sigala Gonzalez, Eng, MEXICO Avril Pérez Fontes, MD, MEXICO Fatima Quintana Trejo, Eng, MEXICO Carlos Leal, MD, Prof., COLOMBIA
Predicting Subsequent Revision ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register Abstract Presentation 5 minutes R. Kyle Martin, MD, FRCSC, UNITED STATES Solvejg Wastvedt, BA, UNITED STATES Ayoosh Pareek, MD, UNITED STATES Andreas Persson, MD, PhD, NORWAY Havard Visnes, MD, PT, PhD, NORWAY Anne Marie Fenstad, MSc, NORWAY Gilbert Moatshe, MD, PhD, NORWAY Julian Wolfson, PhD, UNITED STATES Lars Engebretsen, MD, PhD, NORWAY
Ligamentous Laxity, Male Sex, Chronicity, Meniscus Injury And Posterior Tibial Slope Are Associated With A High-Grade Pre-Operative Pivot Shift: A Post Hoc Analysis Of The Stability Study Abstract Presentation 6 minutes Lachlan Batty, FRACS, AUSTRALIA Andrew Firth, PhD, CANADA Gilbert Moatshe, MD, PhD, NORWAY Dianne M. Bryant, PhD, CANADA S. Mark A. Heard, MD, FRCS, CANADA Robert G. McCormack, MD, CANADA Alex Rezansoff, MD, FRCSC, CANADA Devin Clarke Peterson, MD, FRCSC, Dip Sport Med, CANADA Davide Bardana, MD, CANADA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity ePoster Presentation Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin), INDIA Souvik Paul, MBBS, MS Orthopedics (AIIMS), DNB, MCh, Dip SICOT, INDIA Lakshmana Das Sekar, MS, DNB Orthopaedics, INDIA Arghya Kundu Choudhury, MS, MCh Joint replacement and reconstruction, INDIA

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Same Knee, Different Goals: Patients and Surgeons have Different Priorities Related to ACL Reconstructions and Surgeons are Resistant to Changing Clinical Practice

Same Knee, Different Goals: Patients and Surgeons have Different Priorities Related to ACL Reconstructions and Surgeons are Resistant to Changing Clinical Practice

Background

Purpose

Methods

Results

Conclusion

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Same Knee, Different Goals: Patients and Surgeons have Different Priorities Related to ACL Reconstructions and Surgeons are Resistant to Changing Clinical Practice

Same Knee, Different Goals: Patients and Surgeons have Different Priorities Related to ACL Reconstructions and Surgeons are Resistant to Changing Clinical Practice

Background

Purpose

Methods

Results

Conclusion

More ISAKOS 2021: Global Content