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Dean RS, Hafen TJ, Braithwaite CL, Farley KX, LaPrade RF, Guettler JH, Bicos J. Patient Perception of Allograft Versus Autograft in ACL Reconstruction Using a Validated Online Survey Marketplace. Orthop J Sports Med 2024; 12:23259671241263853. [PMID: 39165330 PMCID: PMC11334250 DOI: 10.1177/23259671241263853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/02/2024] [Indexed: 08/22/2024] Open
Abstract
Background Little is known regarding the opinions of the general population on anterior cruciate ligament (ACL) graft options. Purpose To evaluate the general population's perception of the use of allografts versus autografts in ACL reconstruction using a previously validated online marketplace platform. Methods A prospective 34-question survey was distributed via the online marketplace. After collecting baseline demographics, participant preferences for ACL reconstruction with an allograft or autograft were established. All respondents completed a preeducation survey, reviewed an evidence-based education sheet, and completed a posteducation survey to assess their understanding. Upon completion, participants were asked which graft they would prefer. Participants were then asked if they would be willing to change their preference based on surgeon recommendation. Finally, participants were asked to rank the factors from the education sheet that were most influential. Study Design Cross-sectional study. Results There were 491 participants that completed the survey (mean age, 39.9 years [range, 19-72 years]; 244 male, 241 female, and 6 nonbinary/third-gender participants). Before reading the education sheet, 276 (56%) reported no graft preferences, 146 (30%) preferred autograft, and 69 (14%) preferred allograft. After reading the provided sheet, 226 (46%) participants preferred autograft, 185 (38%) preferred allograft, and 80 (16%) had no preference. The mean score on the preeducation test was 45%, and the mean score on the posteducation test was significantly greater (61%; P < .01). Overall, 345 participants (83.9%) stated they would change their preference for autograft or allograft if their surgeon recommended it. Surgeon preference (n = 330; 67%), educational information provided (n = 117; 24%), and previous knowledge (n = 44; 9%) were the most important factors for making graft selections. The mean ages of the participants selecting each graft type before and after education were as follows: allograft (37.8 ± 10.1 vs 40.6 ± 11.8 years; P = .05), autograft (38 ± 11.5 vs 39.5 ± 10.1 years; P = .21), and no preference (41.5 ± 11.2 vs 39.4 ± 11.8 years; P = .16). Conclusion Education resulted in a greater number of individuals' reporting a preference in graft type (either allograft or autograft) compared with preinformation questioning. In addition, 83.9% of the participants were willing to switch their graft choice if recommended by their surgeon.
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Affiliation(s)
- Robert S. Dean
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
| | - Tanner J. Hafen
- William Beaumont School of Medicine, Oakland University, Auburn Hills, Michigan, USA
| | - Collin L. Braithwaite
- William Beaumont School of Medicine, Oakland University, Auburn Hills, Michigan, USA
| | - Kevin X. Farley
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
| | | | - Joseph H. Guettler
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
| | - James Bicos
- Department of Orthopaedics, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA
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Pearsall C, Chen AZ, Abdelaziz A, Saltzman BM, Piasecki DP, Popkin CA, Redler LH, Levine WN, Ahmad CS, Trofa DP. Patient Preferences for Graft Selection in Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med 2024; 12:23259671241258429. [PMID: 39157023 PMCID: PMC11328237 DOI: 10.1177/23259671241258429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/26/2024] [Indexed: 08/20/2024] Open
Abstract
Background Selecting an appropriate graft for anterior cruciate ligament (ACL) reconstruction requires consideration of a patient's preferences, goals, age, and physical demands alongside the risks and benefits of each graft choice. Purpose To determine the most popular ACL reconstruction grafts among patients and the most important factors influencing their decisions. Study Design Cross-sectional study; Level of evidence, 3. Methods Patients undergoing ACL reconstruction between October 2022 and April 2023 completed a survey either before (nonconsult group) or after (consult group) speaking with their surgeon, who provided an evidence-based description of the pros and cons of an allograft and the following autografts: bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT). Patient characteristics, graft choice, information influencing their graft choice, and surgeon recommendation were collected and compared between the groups. Results Among the 100 included patients, 59.0% were male, and the mean age was 28.3 ± 10.4 years. The most popular grafts were the BPTB (56.0%), followed by the QT (29.0%), HT (8.0%), and allograft (7.0%). No significant difference was observed in the graft selection between the consult group (n = 60; BPTB, 46.7%; QT, 38.3%; HT, 8.3%; allograft, 6.7%) and nonconsult group (n = 40; BPTB, 70.0%; QT, 15.0%; HT, 7.5%; allograft, 7.5%) (P = .0757). In the consult group, 81.7% of patients selected the graft recommended to them by their surgeon. The top 2 graft selection reasons were usage in professional athletes and failure rates, while the top 2 ACL surgery concerns were returning to their desired level of athletics and graft failure risk. Among the 93 patients who researched their ACL graft options before their visit, the most popular information source was some form of media (72.0% [67/93]). Conclusion The study findings underscore the importance of patient preference and surgeon recommendation in a patient's graft selection and highlight the need to be cognizant of the information sources available to patients when researching their graft options.
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Affiliation(s)
- Christian Pearsall
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Aaron Z. Chen
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Abed Abdelaziz
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Bryan M. Saltzman
- OrthoCarolina Sports Medicine Center, Charlotte, North Carolina, USA
- Atrium Health Musculoskeletal Institute, Charlotte, North Carolina, USA
| | - Dana P. Piasecki
- OrthoCarolina Sports Medicine Center, Charlotte, North Carolina, USA
- Atrium Health Musculoskeletal Institute, Charlotte, North Carolina, USA
| | - Charles A. Popkin
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Lauren H. Redler
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - William N. Levine
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Christopher S. Ahmad
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
| | - David P. Trofa
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York, USA
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Mousavibaygei S, Gerami M, Haghi F, Pelarak F. Anterior cruciate ligament (ACL) injuries: A review on the newest reconstruction techniques. J Family Med Prim Care 2022; 11:852-856. [PMID: 35495824 PMCID: PMC9051673 DOI: 10.4103/jfmpc.jfmpc_1227_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/09/2021] [Accepted: 11/10/2021] [Indexed: 11/04/2022] Open
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Thapa DK, Visentin DC, Kornhaber R, West S, Cleary M. The influence of online health information on health decisions: A systematic review. PATIENT EDUCATION AND COUNSELING 2021; 104:770-784. [PMID: 33358253 DOI: 10.1016/j.pec.2020.11.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/23/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This systematic review assessed the influence of online health information (OHI) search behaviour on health and medical decisions. METHODS Eligible studies were identified by searching electronic databases PubMed, Scopus, and CINAHL in February 2020 for studies reporting OHI search behaviour and its influence on health decisions. Information was extracted pertaining to either consumers' (self-reported) perceptions of the influence of OHI on decision-making or the association between online search behaviour and health decision-making. RESULTS A total of 3995 articles were screened, with 48 included in the final analysis. The reviewed studies indicated that OHI assisted in making subsequent health related decisions such as asking questions during a consultation, increased professional visits, improved adherence to the advice of a physician, being more compliant with taking medication, and improved self-care. CONCLUSION Consumers largely used OHI to support information provided by their physicians. The strength of the patient-provider relationship was considered important in moderating the potential negative outcomes of OHI. PRACTICE IMPLICATIONS Health care systems have a unique opportunity to direct OHI search behaviours towards empowering consumers to engage as an informed, active and joint decision-maker in their own health care.
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Affiliation(s)
- Deependra K Thapa
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
| | - Denis C Visentin
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
| | - Rachel Kornhaber
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
| | - Sancia West
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
| | - Michelle Cleary
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia.
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Ugwuoke A, Syed F, El-Kawy S. Predicting adequacy of free quadriceps tendon autograft, for primary and revision ACL reconstruction, from patients' physical parameters. Knee Surg Sports Traumatol Arthrosc 2020; 28:448-453. [PMID: 31363806 DOI: 10.1007/s00167-019-05640-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE Free quadriceps tendon autograft (QTA) has gained popularity for both primary and revision ACL reconstruction. The aim of this study is to measure the dimensions of quadriceps tendon and determine its correlation with patient's height, weight and BMI. This is to provide a guide for patients and surgeons in predicting the suitability of QTA for ACL reconstructions. METHODS A cross-sectional study in which the length and thickness of the quadriceps tendon was measured in 51 Caucasian patients who underwent primary total knee arthroplasty. Exclusion criteria include non-Caucasians and previous tendon pathology. Patients were selected from routine elective total knee arthroplasty list. Tendon length is taken from musculotendinous junction to its insertion. Thickness was measured at midpoint and at distal insertion. Patients' height, weight and BMI were recorded. The correlation between patient physical parameters and tendon dimensions were determined. RESULTS Subjects' median age was 65 years (range 44-87), with 34 females and 17 males. Median length of the tendon was 9 mm (range 70-110), and median insertional thickness was 9 mm (7-10 mm). Median thickness at midpoint was 7 mm (range 4-10 mm). There was moderately positive correlation between subjects' height and tendon length (correlation coefficient 0.50), and also between weight and tendon length (correlation coefficient 0.47). There was no significant correlation between subjects' BMI and the tendon length. There was also no significant correlation between tendon thickness and subject's physical parameters. CONCLUSION This study has shown that most patients could provide adequate QTA for ACL reconstruction. It also points to the fact that no investigation is required to predict the adequacy of QTA. Though further studies with larger sample size are required to confirm this, clinician can rely on analysing patients' physical parameter in predicting the adequacy of QTA for ACL reconstruction. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Anthony Ugwuoke
- Department of Orthopaedics, Warwick Hospital, Lakin Road, Warwick, CV34 5BW, UK.
| | - Farhan Syed
- Trauma and Orthopaedics, Warwick Hospital, Warwick, UK
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Samitier G, Vinagre G. Hamstring Braid Graft Technique for Anterior Cruciate Ligament Reconstruction. Arthrosc Tech 2019; 8:e815-e820. [PMID: 31696044 PMCID: PMC6823734 DOI: 10.1016/j.eats.2019.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/19/2019] [Indexed: 02/03/2023] Open
Abstract
Hamstring autograft is one of the most used grafts for anterior cruciate ligament (ACL) reconstruction, although there are several graft preparation techniques. It is extremely difficult to mimic the biomechanical properties of the native ACL; thus, it is important to achieve a proper graft configuration, diameter, and length. To avoid reruptures, an optimal and reproducible hamstring autograft is desired. Hamstring autograft has been traditionally devalued when compared with other options such as bone-patellar tendon-bone autograft. The purpose of this Technical Note is to describe in detail a hamstring braid graft configuration that could potentially overcome the past disadvantages of ACL reconstruction.
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Affiliation(s)
- Gonzalo Samitier
- Department of Orthopaedic Surgery and Traumatology, Hospital General de Villalba, Madrid, Spain
| | - Gustavo Vinagre
- Department of Orthopaedic Surgery and Traumatology, Hospital de Verín, Galicia, Spain
- Address correspondence to Gustavo Vinagre, M.D., Ph.D., Department of Orthopaedic Surgery and Traumatology, Hospital de Verín, Av. de Laza, 0, 32600 Verín, Ourense, Spain.
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Bai F, Ling J, Esoimeme G, Yao L, Wang M, Huang J, Shi A, Cao Z, Chen Y, Tian J, Wang X, Yang K. A systematic review of questionnaires about patient's values and preferences in clinical practice guidelines. Patient Prefer Adherence 2018; 12:2309-2323. [PMID: 30464419 PMCID: PMC6220727 DOI: 10.2147/ppa.s177540] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE We conducted a systematic review to evaluate questionnaires about patient's values and preferences to provide information on the most appropriate questionnaires to be used when developing clinical practice guidelines. METHODS A systematic literature search of the Cochrane Library, MEDLINE, Embase, Web of Science, Chinese Biomedical Database, China National Knowledge Infrastructure, and the Wanfang Database was performed to identify studies on questionnaires evaluating patient's values and preferences. The articles that used fully structured questionnaires or scales with standardized questions and answer options were included. We assessed the questionnaires' construction and content with a psychometric methodology and summarized the domains and items about patient's preferences and values. RESULTS A total of 7,008 records were retrieved by the search strategy and scanned, and 20 articles were finally included. Of these, 10 (50%) articles described the process of item generation and only four questionnaires (20%, 4/20) mentioned the pilot testing. Regarding "validity", seven questionnaires (35%, 7/20) assessed validity and only one (5%, 1/20) questionnaire assessed internal consistency, with Cornbrash's α values of 0.74-0.87. For "acceptability", the time to complete the questionnaires ranged from 10 to 30 minutes and only nine studies (45%, 9/20) reported the response rates. In addition, the results of domains and items about patient's preferences and values showed that the "effectiveness" domain was the most considered item in the patient's value questionnaire followed by "safety", "prognosis", and others, whereas the least considered domain was "physician's experience". CONCLUSION Only a few studies have developed questionnaires with rigorous psychometric methods to measure patient's preferences and values. Currently, still there is no valid or reliable questionnaire for patient's preferences and values for use when developing clinical practice guidelines. Further study should be conducted to develop standardized instruments to measure patient's preferences and values. This study provides the domains and items that may be used in formulating questionnaires about patient's preferences and values.
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Affiliation(s)
- Fei Bai
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China, ;
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China, ;
- National Center for Medical Administration Service, Beijing, China
| | - Juan Ling
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China, ;
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China, ;
| | - Gloria Esoimeme
- University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
| | - Liang Yao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China, ;
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China, ;
| | - Mingxia Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Jiajun Huang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Anchen Shi
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Zehui Cao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China, ;
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China, ;
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China, ;
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China, ;
| | - Xiaoqin Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China, ;
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China, ;
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China, ;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China, ;
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China, ;
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Devitt BM, Hartwig T, Klemm H, Cosic FT, Green J, Webster KE, Feller JA, Baker JF. Comparison of the Source and Quality of Information on the Internet Between Anterolateral Ligament Reconstruction and Anterior Cruciate Ligament Reconstruction: An Australian Experience. Orthop J Sports Med 2017; 5:2325967117741887. [PMID: 29242806 PMCID: PMC5724647 DOI: 10.1177/2325967117741887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: The internet is a valuable tool, but concerns exist regarding the quality and accuracy of medical information available online. Purpose: To evaluate the source and quality of information on the internet relating to anterolateral ligament reconstruction (ALLR) compared with anterior cruciate ligament reconstruction (ACLR). Study Design: Cross-sectional study. Methods: A questionnaire was administered to 50 ACLR patients in Australia to determine their use of the internet to research their operation and their familiarity with the anterolateral ligament (ALL) of the knee. The most common search terms were determined, and the first 70 websites returned by the 5 most popular search engines were used to assess the quality of information about ACLR and ALLR. Each site was categorized by type and was assessed for quality and validity using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria, and a novel specific content score for each procedure. The presence of the Health on the Net Code (HONcode) seal was also recorded. Results: The majority (84%) of ACLR patients used the internet to research their operation. The quality of information available for ALLR was significantly inferior to that for ACLR according to the DISCERN score (37.3 ± 3.4 vs 54.4 ± 4.6; P < .0001) and specific content score (5.3 ± 1.3 vs 11.0 ± 1.5; P < .0001). ACLR websites were predominantly physician produced, while the majority of ALLR websites were academic. In contrast to ACLR websites, the majority of ALLR websites did not provide information on the indication for treatment or potential complications. ALLR websites scored better on the JAMA benchmark criteria due to the predominance of academic websites. A greater proportion of ACLR websites (14.6%) versus ALLR websites (2.5%) provided an HONcode seal. Correlation was demonstrated between the DISCERN score and specific content scores for both ACLR and ALLR but not with JAMA benchmark criteria. The specific content score had high reliability for both ACLR and ALLR. Conclusion: The majority of patients undergoing ACLR in Australia used the internet to research the procedure. The quality of information on the internet relating to ALLR was significantly inferior to information about ACLR. Most ALLR websites failed to include crucial information about the indication or options for treatment, prognosis, and potential complications. Surgeons should be aware of the information to which their patients are exposed through the internet and should be proactive in directing patients to appropriate websites.
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Affiliation(s)
- Brian M Devitt
- OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia.,School of Allied Health, La Trobe University, Melbourne, Australia
| | - Taylor Hartwig
- OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia
| | - Haydn Klemm
- OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia
| | - Filip T Cosic
- OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia
| | - James Green
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Kate E Webster
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Julian A Feller
- OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia
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Vinagre G, Kennedy NI, Chahla J, Cinque ME, Hussain ZB, Olesen ML, LaPrade RF. Hamstring Graft Preparation Techniques for Anterior Cruciate Ligament Reconstruction. Arthrosc Tech 2017; 6:e2079-e2084. [PMID: 29349000 PMCID: PMC5766355 DOI: 10.1016/j.eats.2017.08.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/04/2017] [Indexed: 02/03/2023] Open
Abstract
Anterior cruciate ligament reconstruction is one of the most commonly performed procedures in orthopaedics, with more than 125,000 performed in the United States per year. There are several reconstruction graft choices that can be used to reconstruct the native anterior cruciate ligament, with autograft hamstring tendons being one of the most commonly used. Preparation of a hamstring autograft varies depending on patient characteristics and physician preference. The purpose of this Technical Note is to describe in detail different variants of hamstring graft preparation techniques that are commonly used in practice.
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Affiliation(s)
| | | | - Jorge Chahla
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | - Mark E. Cinque
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | | | - Morten L. Olesen
- Orthopedic Research Laboratory, Aarhus University Hospital, Aarhus, Denmark
| | - Robert F. LaPrade
- The Steadman Clinic, Vail, Colorado, U.S.A.,Steadman Philippon Research Institute, Vail, Colorado, U.S.A.,Address correspondence to Robert F. LaPrade, M.D., Ph.D., Steadman Philippon Research Institute, The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO 81657, U.S.A.Steadman Philippon Research InstituteThe Steadman Clinic181 West Meadow DriveSuite 400VailCO81657U.S.A.
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Ekhtiari S, Kay J, de Sa D, Simunovic N, Musahl V, Peterson DC, Ayeni OR. What Makes a Successful Survey? A Systematic Review of Surveys Used in Anterior Cruciate Ligament Reconstruction. Arthroscopy 2017; 33:1072-1079.e3. [PMID: 28351554 DOI: 10.1016/j.arthro.2017.01.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 01/03/2017] [Accepted: 01/05/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To characterize and assess the methodological quality of patient and physician surveys related to anterior cruciate ligament reconstruction, and to analyze the factors influencing response rate. METHODS The databases MEDLINE, Embase, and PubMed were searched from database inception to search date and screened in duplicate for relevant studies. Data regarding survey characteristics, response rates, and distribution methods were extracted. A previously published list of recommendations for high-quality surveys in orthopaedics was used as a scale to assess survey quality (12 items scored 0, 1, or 2; maximum score = 24). RESULTS Of the initial 1,276 studies, 53 studies published between 1986 and 2016 met the inclusion criteria. Sixty-four percent of studies were distributed to physicians, compared with 32% distributed to patients and less than 4% to coaches. The median number of items in each survey was 10.5, and the average response rate was 73% (range: 18% to 100%). In-person distribution was the most common method (40%), followed by web-based methods (28%) and mail (25%). Response rates were highest for surveys targeted at patients (77%, P < .0001) and those delivered in-person (94%, P < .0001). The median quality score was 12/24 (range = 8.5/24 to 21/24). There was high inter-rater agreement using the quality scale (intraclass correlation coefficient = 0.92), but there was no correlation with the response rate (Rho = -0.01, P = .97). CONCLUSIONS Response rates vary based on target audience and distribution methods, with patients responding at a significantly higher rate than physicians and in-person distribution yielding significantly higher response rates than web or mail surveys. LEVEL OF EVIDENCE Level IV, systematic review of Level IV studies.
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Affiliation(s)
- Seper Ekhtiari
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jeffrey Kay
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Darren de Sa
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Simunovic
- Centre for Evidence Based Orthopaedics, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Volker Musahl
- Division of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Devin C Peterson
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
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Vaishya R, Agarwal AK, Ingole S, Vijay V. Current practice variations in the management of anterior cruciate ligament injuries in Delhi. J Clin Orthop Trauma 2016; 7:193-9. [PMID: 27489416 PMCID: PMC4949409 DOI: 10.1016/j.jcot.2015.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 12/27/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The aim of this study was to determine the current practices and preferences of the arthroscopic surgeons of Delhi in the diagnosis, treatment and rehabilitation of patients with anterior cruciate ligament (ACL) injury. METHODS It was a cross-sectional descriptive study conducted among arthroscopic surgeons of Delhi. A survey was conducted using a questionnaire that was sent either by e-mail or by direct contact to all sixty arthroscopic surgeons of Delhi. RESULTS Forty-eight (80%) surgeons responded to our questionnaire. Maximum participants (83.3%) used semitendinosus/gracilis tendon autograft for ACL reconstruction (ACLR) and only 2.1% were using bone-patellar-tendon-bone (BPTB) autograft. Most preferred method of graft fixation was an 'interference screw' on the tibial side and an 'endobutton' on the femoral side, which was preferred by 95.83% and 93.75% surgeons, respectively. Almost all respondents (97%) used a bio-absorbable interference screw for tibial side graft fixation. Postoperative bracing was advised for <3 weeks by 47.9% surgeons and for 3-6 weeks by 31.3%. The results were analysed using statistical analysis. CONCLUSION Surgeon preferences in ACLR differ considerably among the arthroscopic surgeons of Delhi. There is majority consensus for using Hamstring autograft (single bundle) with a suspensory fixation on the femoral side and an aperture fixation on the tibial side. Transportal technique of making the femoral tunnel and preservation of amputation stump were the preferred methods. However, differences exist over the timing of surgery, rehab after surgery, pain management, etc.
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Affiliation(s)
- Raju Vaishya
- Professor, Senior Consultant Orthopaedics, Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi 110076, India
| | - Amit Kumar Agarwal
- Consultant Orthopaedics, Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi 110076, India
- Corresponding author. Tel.: +91 9968578514.
| | - Sachin Ingole
- Orthopaedic Registrar, Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi 110076, India
| | - Vipul Vijay
- Consultant Orthopaedics, Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi 110076, India
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Lee DH, Lee JH, Jeong HJ, Lee SJ. Serial changes in knee muscle strength after anterior cruciate ligament reconstruction using hamstring tendon autografts. Arthroscopy 2015; 31:890-5. [PMID: 25771424 DOI: 10.1016/j.arthro.2014.12.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 11/20/2014] [Accepted: 12/03/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to evaluate serial changes in quadriceps and hamstring muscle strength over the first postoperative year in patients who underwent anterior cruciate ligament (ACL) reconstruction with an autologous hamstring tendon graft and to reveal which of these 2 muscles lost more strength and recovered more slowly after autologous hamstring ACL reconstruction. METHODS Isokinetic muscle strength was measured preoperatively and at 6 months and 1 year postoperatively in 20 patients who underwent ACL reconstruction. The maximal torque (60°/s) and total work (180°/s) of the quadriceps and hamstring were evaluated using an isokinetic testing device. The isokinetic muscle strength and endurance of the injured legs were expressed as percentages of those of the uninjured legs at the same time point. RESULTS Both quadriceps and hamstring muscle strength at 60°/s and endurance at 180°/s of the injured relative to the uninjured leg was 50% preoperatively. Quadriceps muscle strength and endurance of the injured leg increased to 70% at 6 months and 80% at 1 year postoperatively, whereas hamstring muscle strength and endurance increased to 80% at 6 months and 80% at 1 year. CONCLUSIONS Knee muscle strength recovered progressively after ACL reconstruction using autologous hamstring tendons but did not fully recover, being about 80% that of the uninjured leg even 1 year after surgery. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Dae-Hee Lee
- Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Jin-Hyuck Lee
- Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Hye-Jin Jeong
- Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Seok-Joo Lee
- Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
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Affiliation(s)
- Ish Kumar Dhammi
- Department of Orthopaedics, Guru Teg Bahadur Hospital, UCMS, New Delhi, India,Address for correspondence: Dr. Ish Kumar Dhammi, Department of Orthopaedics, Guru Teg Bahadur Hospital and UCMS, Dilshad Garden, New Delhi - 110 095, India. E-mail:
| | - Rehan-Ul-Haq
- Department of Orthopaedics, Guru Teg Bahadur Hospital, UCMS, New Delhi, India
| | - Sudhir Kumar
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
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Bruce-Brand RA, Baker JF, Byrne DP, Hogan NA, McCarthy T. Assessment of the quality and content of information on anterior cruciate ligament reconstruction on the internet. Arthroscopy 2013; 29:1095-100. [PMID: 23582738 DOI: 10.1016/j.arthro.2013.02.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/29/2013] [Accepted: 02/01/2013] [Indexed: 02/02/2023]
Abstract
The Internet has become a major source of health information for the public. However, there are concerns regarding the quality, accuracy, and currency of medical information available online. We assessed the quality of information about anterior cruciate ligament (ACL) reconstruction on the first 60 websites returned by the 4 most popular search engines. Each site was categorized by type and assessed for quality and validity using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria, and a novel ACL reconstruction-specific content score. The presence of the Health On the Net Code (HONcode), a purported quality assurance marker, was noted. The quality of information on ACL reconstruction available online is variable, with many websites omitting basic information regarding treatment options, risks, and prognosis. Commercial websites predominate. Academic and allied health professional websites attained the highest DISCERN and JAMA benchmark scores, whereas physician sites achieved the highest content scores. Sites that bore the HONcode seal obtained higher DISCERN and ACL reconstruction content scores than those without this certification. The HONcode seal is a reliable indicator of website quality, and we can confidently advise our patients to search for this marker.
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Duncan IC, Kane PW, Lawson KA, Cohen SB, Ciccotti MG, Dodson CC. Evaluation of information available on the Internet regarding anterior cruciate ligament reconstruction. Arthroscopy 2013; 29:1101-7. [PMID: 23591383 DOI: 10.1016/j.arthro.2013.02.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 02/01/2013] [Accepted: 02/08/2013] [Indexed: 02/02/2023]
Abstract
Searching the Internet is one of the most popular methods for acquiring information related to health. The Internet offers physicians and patients easy access to a wide range of medical material from anywhere in the world. For many patients, this information helps formulate decisions related to their health and health care. An important caveat is that virtually anything can be published on the Internet. Although academic publications require rigorous peer review, Internet websites have no regulatory body monitoring quality and content. With a lack of external regulation, the information retrieved may be incorrect or outdated. The Internet can be a valuable asset for educating patients, but because of significant variability physicians should be familiar with the quality of information available. This article discusses both the strengths and weaknesses of information available on the Internet regarding anterior cruciate ligament repair.
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Affiliation(s)
- Ian C Duncan
- The Rothman Institute, Thomas Jefferson Sports Medicine Division, Philadelphia, PA 19010, USA
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Noh JH, Yang BG, Yi SR, Roh YH, Lee JS. Hybrid tibial fixation for anterior cruciate ligament reconstruction with Achilles tendon allograft. Arthroscopy 2012; 28:1540-6. [PMID: 22732367 DOI: 10.1016/j.arthro.2012.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 03/11/2012] [Accepted: 03/12/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare clinical outcomes of tibial fixation between a biodegradable interference screw only and a biodegradable interference screw supplemented by a post-tie using a washer screw in single-bundle anterior cruciate ligament (ACL) reconstruction with 2-strand free tendon Achilles allograft in active young men. METHODS A prospective study was performed in 80 subjects who underwent single-bundle ACL reconstruction. A 2-strand free tendon Achilles allograft fixed with an EndoButton (Smith & Nephew, Andover, MA) in the femoral tunnel and with a Bio-Interference screw (Arthrex, Naples, FL) in the tibial tunnel was used in group I. Supplementary fixation was performed with a post-tie using a washer screw in group II. The Lachman test, pivot-shift test, International Knee Documentation Committee classification, Lysholm score, range of knee motion, and side-to-side difference were evaluated preoperatively and at the last follow-up. The Tegner activity scale was evaluated before injury and at the last follow-up. The 1-leg hop test was assessed at the last follow-up. RESULTS Of the patients, 36 in group I and 35 in group II could be followed up for at least 2 years. At the last follow-up, 7 patients in group I and 1 in group II showed a 2+ or 3+ on the Lachman test (P = .027). The mean side-to-side difference was 2.9 ± 2.3 mm in group I and 1.4 ± 1.6 mm in group II at the last follow-up (P = .002). The other clinical outcomes were not significantly different between the 2 groups. CONCLUSIONS Supplementary tibial fixation with a post-tie in ACL reconstruction using 2-strand free tendon Achilles allograft was more effective than a biodegradable interference screw only in restoration of the anterior stability of the tibia. LEVEL OF EVIDENCE Level II, randomized controlled trial.
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Affiliation(s)
- Jung Ho Noh
- Kangwon National University Hospital, Chuncheon, South Korea
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Factors Associated with the Adoption of Minimally Invasive Radical Prostatectomy in the United States. J Urol 2012; 188:775-80. [DOI: 10.1016/j.juro.2012.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Indexed: 11/22/2022]
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