Sport as a conditioning factor in the choice of the plasty to reconstruct the anterior cruciate ligament. Epidemiological survey and analysis of the current situation

Abstract

Objective: To know the surgeon’s decision making on the choice of graft in anterior cruciate ligament (ACL) reconstruction surgery according to the sport practiced by the patient. Material and method: An online survey was conducted through the Spanish Society of Sports Traumatology (SETRADE) and the European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA). A descriptive analysis of the sample was performed, and an analysis of the main reason for the choice of plasty was carried out stratifying the sample into different groups. Results: 83 surgeons responded to the survey, 71 members of SETRADE and 12 of ESSKA. The mean number of ACL reconstruction performed per year per respondent was 56 (1-220). For 86.7% of the respondents, sport influenced the decision on the type of graft to be used, the main reason being the biomechanical properties of the plasty (49.4%). The mean agreement in the type of graft to be used in each sport studied was 58.29% (71.1%-38.6%). The highest concordance in the plasty of choice occurred in cycling, with respondents using hamstrings in 71.1% of cases. The sports with the least concordance were wrestling and skiing. There were no statistically significant differences in the reason for choosing plasty. Conclusions: The survey was conducted by a significant number of surgeons with experience in ACL surgery, with biomechanical properties being the main reason for choosing which graft to use. Most of them were influenced in this decision by the type of sport practiced. The authors recommend the handling of at least 2 plasties for primary ACL reconstructions and to individualize each case considering the type of sport in the selection of the graft.