J Knee Surg 2009; 22(1): 7-12
DOI: 10.1055/s-0030-1247719
Original Article

© 2009 Thieme Medical Publishers

Current Trends in Anterior Cruciate Ligament Reconstruction

Thomas R. Duquin, William M. Wind, Marc S. Fineberg, Robert J. Smolinski, Cathy M. Buyea
  • The Department of Orthopaedic Surgery, State University of New York at Buffalo, Buffalo, NY
Further Information

Publication History

Publication Date:
14 January 2010 (online)

ABSTRACT

In 2006, a survey regarding anterior cruciate ligament (ACL) reconstruction was mailed to physician members of the American Orthopaedic Society for Sports Medicine. A total of 993 responses were received from 1747 possible respondents (57%). The number of ACL reconstructions per year ranged from 1 to 275 (mean = 55). 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 were more frequent and hamstring tendon and allografts were less frequent (63%, 25%, and 12%, respectively). A single-incision arthroscopic technique was 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 was 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.

    >