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Anterior Cruciate Ligament Reconstruction Practices of South Asian Association of Regional Cooperation Knee Surgeons: A Pilot Study

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Author(s): Zachary A Kanouse, John Aaron Nyland, Chakra R Pandey.

Journal: Journal of Orthopaedics
ISSN 0972-978X

Volume: 7;
Issue: 2;
Date: 2010;
Original page

Keywords: knee | arthroscopy | survey

ABSTRACT
Objective: Determine the practices of South Asian Association of Regional Cooperation (SAARC) knee surgeons with at least 5 years of ACL reconstruction experience. Methods: A 15-item survey was distributed at the Fourth SAARC Orthopaedic Association Conference. Results: Fourteen surgeons representing five SAARC countries (70% of eligible attendees) completed and returned the survey. Most (42.9%) performed 10-25 ACL reconstructions/year. The primary graft used was a bone-patellar tendon-bone (BPTB) autograft (57.1%). Most (50%) used a BPTB autograft > 95% of the time and a hamstring autograft < 5%, while 43% used a hamstring autograft > 80% of the time and a BPTB autograft < 20%. The primary tibial (85.7%) and femoral (57.1%) fixation was interference screws. Most (62.5%) released BPTB autograft patients back to sports at six months post-surgery. An equal percentage (50%) released hamstring autograft patients back to sports at six or nine months post-surgery. Most (57.1%) did not perceive a benefit changing to an anatomical double bundle ACL reconstruction. Concerns were expressed about patients presenting later following index ACL injury with more associated injuries, referring physicians providing incomplete information, fewer surgical options due to limited resources, the need to improvise techniques, more frequent post-surgery hospitalization, and the need for more educational and technology information exchanges. Conclusions: Most experienced SAARC surgeons performed < 50 ACL reconstructions/year with increasing hamstring autograft use. Concerns were expressed regarding the need for additional resources, for improved educational and technology information exchanges, and for earlier referral with improved documentation. Further study with greater subject numbers and representation from all SAARC countries is needed.
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