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Current trends in repair and rehabilitation of complete (acute) anterior cruciate ligament injuries

Analysis of 1984 questionnaire completed by ACL Study Group

Steamboat Springs Orthopaedics, Steamboat Springs, Colorado

Lonnie E. Paulos, MD

Salt Lake City Knee and Sports Medicine, Salt Lake City, Utah

John A. Feagin, JR, MD, FACS

Jackson Hole Orthopaedics, Jackson, Wyoming

Kenneth L. Lambert, MD

Jackson Hole Orthopaedics, Jackson, Wyoming

H. Ray Cunningham, MD

Jackson Hole Orthopaedics, Jackson, Wyoming

Results of a 21 question survey, taken at the ACL Study Group meeting in 1984, present a composite picture of current practices in ACL reconstruction and rehabilitation. Forty-four of the 50 questionnaires were returned. Responses represented views from knee sur geons in the United States, Canada, Australia, Sweden, and Switzerland. These results were compared with a report of a 1980 international survey in which views of 40 knee experts from the United States, Canada, Eng land, France, and Sweden were summarized. Ques tions on the two surveys were similar, particularly about rehabilitation. Although the time span between the two surveys was only 4 years, we can see both consisten cies and changes. Responses about length of time between ACL repair and full range of motion (by 6 months) were essentially the same (88% in 1980, and 86.4% in 1984). However, changes were evident in length of immobilization (longer in 1980) and prescribing isometric contractions of quadriceps 1 st week postop eratively (more frequently in 1980). Surgeons allowed patients to return to full activity sooner in 1980 than in 1984. Electrical stimulation was being used more fre quently in 1984, and apparently the practice of simul taneous hamstring and quadriceps contraction has come into prominence since 1980 as it was not men tioned in the first survey. In 1984, 50% of the respond ents indicated they prescribed it. Since standardized reporting systems are not established, we cannot do reliable statistical analyses on large samples. At the present time, making surveys with responses from similar groups every few years is the best available way to capture trends in treatment of ACL injuries.

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