Centro di Medicina, Viale della Repubblica 10/B, 31050, Villorba, Treviso, Italy.
2nd Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy.
Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1120-1127. doi: 10.1007/s00167-020-06107-0. Epub 2020 Jun 26.
The objective of this study was to report on a worldwide web-based survey among the ESSKA community developed to investigate current recommendations regarding ACL reconstruction surgical procedures.
All contacts in the official mailing list of the ESSKA were contacted to investigate preferences regarding graft type, anterolateral ligament reconstruction, femoral tunnel drilling technique, single-bundle vs double-bundle technique, femoral and tibial fixation methods.
Eight-hundred and twenty responses were analyzed. Hamstrings autograft was the graft of choice in male patients for 634 (79%) and in female patients for 674 (84%) responders, while its preference for ACL reconstruction in professional athletes was for 401 (50%). 480 (63%) surgeons surveyed would include anterolateral ligament reconstruction only if diagnosed and remaining instability after ACL surgery or revision. 598 (75%) respondents were in favor of anteromedial portal for femoral tunnel drilling. The most popular femoral fixation technique was found to be cortical suspension (500-66%), while a compression system was preferred on the tibial side by 537 (71% of the sample).
This survey study found that HT autograft, single-bundle reconstruction, anteromedial portal for femoral tunnel drilling, cortical suspension systems for femoral fixation and compression systems for tibial fixation represent the current standard of ACLR in a large community of orthopedic surgeons. The present study performed with surgeons who are members of the ESSKA community will help to comprehend the actual ACLR worldwide practice patterns. Due to low response rate, these results should be interpreted with caution and not to be intended to represent the state of the art of ESSKA community.
III.
本研究旨在报告一项针对 ESSKA 社区的全球网络调查，旨在调查目前关于 ACL 重建手术程序的建议。
联系 ESSKA 官方邮件列表中的所有联系人，以调查他们对移植物类型、前外侧韧带重建、股骨隧道钻孔技术、单束与双束技术、股骨和胫骨固定方法的偏好。
分析了 820 份回复。对于 634 名（79%）男性患者和 674 名（84%）女性患者，自体腘绳肌移植物是首选的移植物，而对于职业运动员的 ACL 重建，401 名（50%）更喜欢自体腘绳肌移植物。480 名（63%）调查的外科医生只有在 ACL 手术后或翻修后诊断出和仍然存在不稳定时才会包括前外侧韧带重建。598 名（75%）受访者赞成在前内侧入路进行股骨隧道钻孔。最受欢迎的股骨固定技术是皮质悬吊（500-66%），而在胫骨侧，压缩系统更受 537 名（样本的 71%）受访者的青睐。
这项调查研究发现，HT 自体移植物、单束重建、前内侧入路进行股骨隧道钻孔、皮质悬吊系统用于股骨固定、压缩系统用于胫骨固定，代表了骨科医生中 ACLR 的当前标准。这项在 ESSKA 社区成员中进行的研究将有助于理解全球范围内 ACLR 的实际实践模式。由于回复率低，这些结果应谨慎解释，不应旨在代表 ESSKA 社区的最新技术状态。
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