Survey Study of Canadian Orthopedic Surgeons on the Surgical Management of Anterior Cruciate Ligament Injury

OBJECTIVE: To determine current trends in surgical technique and postoperative rehabilitation of anterior cruciate ligament (ACL) reconstruction among Canadian orthopedic surgeons, with comparison with the previous survey study in 2008. DESIGN: Descriptive study. SETTING: Data were collected at the Pan Am Clinic, a sports medicine clinic in Winnipeg, Canada. PARTICIPANTS: Active members of the Canadian Orthopaedic Association and Arthroscopic Association of Canada. INTERVENTION: N/A. MAIN OUTCOME MEASURES: Number of surgeons selecting preferred surgical techniques (graft type, method of femoral tunnel drilling) and postoperative rehabilitation protocols (return to sport criteria) for ACL reconstruction were assessed and compared with 2008 survey findings. RESULTS: Responses from 91 participants were included. Consistent with the findings in 2008, hamstring tendon autograft remained the most common graft choice in 2022, with 79.1% of surgeons selecting this graft. Quadriceps tendon accounted for 8.8% of responses. The preferred technique for femoral tunnel creation shifted from transtibial drilling (69.9%, 2008) to anteromedial portal drilling (77.4%, 2022). In addition, 80.6% of surgeons used functional assessment criteria to determine return to sport, with testing performed by themselves or by other professionals. CONCLUSIONS: This survey study provides an important update of the current preferences among Canadian orthopedic surgeons regarding ACL reconstruction. In addition to demonstrating the impact of evidence-based medicine on surgical management, the trends identified in this study also serve as a benchmark against which other surgeons can compare their own surgical techniques and clinical decision-making.