Knee immobilization in the immediate post-operative period following ACL reconstruction: a survey of practice patterns of Canadian orthopedic surgeons.
OBJECTIVE
This study was designed to determine the practice patterns and rationale for knee immobilizer use in immediate post-operative period following an anterior cruciate ligament (ACL) reconstruction.


METHODS
Descriptive cross-sectional survey.


METHODS
Canada.


METHODS
A random sample of 50% of Canadian orthopedic surgeons registered with the Canadian Orthopaedic Association (COA).


METHODS
Self-reported survey responses regarding knee immobilizer use, surgeon characteristics, graft type and type of practice.


RESULTS
Complete survey response rate was 36.1% (122/338). There was a lack of consensus regarding knee immobilizer use; 47.7% of responding surgeons use a knee immobilizer in the immediate post-operative period while 52.3% do not. There were no trends in characteristics such as fellowship training, number of years in practice and type of practice between surgeons who use and do not use a knee immobilizer. The reported reasons for immobilization were: pain reduction in the post-operative period (51.6%), graft site protection (38.7%), maintaining full extension (19.4%) and habit (12.9%). The length of time the immobilizer was used ranged from 5-42 days.


CONCLUSIONS
The lack of consensus reported in the current study and published literature reflects a lack of scientific evidence in the area of post-operative knee immobilization. The need for a randomized clinical trial to assess the efficacy of knee immobilizer use after ACL reconstruction is evident. The authors recommend using peri-operative pain as an outcome measure in future studies investigating immobilization in the immediate post-operative period.
Hiemstra
Laurie A
LA
Mineral Springs Hospital, Banff, AB, Canada. hiemstra@banffsport-med.ca
Veale
Kim
K
Sasyniuk
Treny
T
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D002170:Canada; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007103:Immobilization / Q000379:methods / Q000706:statistics & numerical data*; D007718:Knee Injuries / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D009985:Orthopedics; D011182:Postoperative Care / Q000379:methods; D010818:Practice Patterns, Physicians'; D019651:Plastic Surgery Procedures / Q000379:methods