Purpose
The purpose of this study was to assess factors associated with patient selection
of graft type for anterior cruciate ligament (ACL) reconstruction.
Methods
We retrospectively identified 1,038 patients who underwent ACL reconstruction over
a 5-year period. Surgery was performed by 5 different surgeons. A questionnaire was
sent to patients at a minimum of 24 months' follow-up to determine which type of graft
was used, why they chose that graft, whether they were satisfied with their graft
and outcome, and whether they would choose another graft and, if so, which one; it
also included a visual analog scale to rate their recovery.
Results
Questionnaires were received from 240 patients. The mean follow-up from the time of
surgery was 41.3 months (range, 24 to 96 months). There were a variety of allografts
and autografts used. Overall, allograft was used in 63.3% of patients and autograft
in 35.4%. The most common factor influencing graft selection was physician recommendation
(74.2%). Patients rated their recovery on average as 8.48 (±1.8) out of 10 on the
visual analog scale (range, 0 to 10). Of the patients, 93% were satisfied with their
graft selection. Only 12.7% would choose another graft if in the situation again.
Of these patients, 63.3% would change from an autograft to allograft.
Conclusions
This study suggests that the most important factor for a patient choosing a graft
for ACL reconstruction is physician recommendation. Our study has shown an increasing
trend in our group toward the use of allograft materials for ACL reconstruction (63.3%
of all graft materials selected). Of the individuals who were dissatisfied with their
graft, 63% who originally chose autograft would choose allograft as a source in the
future.
Level of Evidence
Level III, prognostic case-control study.
Key Words
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Article info
Publication history
Accepted:
February 17,
2009
Received:
July 26,
2008
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
