Factors affecting patient selection of graft type in anterior cruciate ligament reconstruction.
OBJECTIVE
The purpose of this study was to assess factors associated with patient selection of graft type for anterior cruciate ligament (ACL) reconstruction.


METHODS
We retrospectively identified 1,038 patients who underwent ACL reconstruction over a 5-year period. Surgery was performed by 5 different surgeons. A questionnaire was sent to patients at a minimum of 24 months' follow-up to determine which type of graft was used, why they chose that graft, whether they were satisfied with their graft and outcome, and whether they would choose another graft and, if so, which one; it also included a visual analog scale to rate their recovery.


RESULTS
Questionnaires were received from 240 patients. The mean follow-up from the time of surgery was 41.3 months (range, 24 to 96 months). There were a variety of allografts and autografts used. Overall, allograft was used in 63.3% of patients and autograft in 35.4%. The most common factor influencing graft selection was physician recommendation (74.2%). Patients rated their recovery on average as 8.48 (+/-1.8) out of 10 on the visual analog scale (range, 0 to 10). Of the patients, 93% were satisfied with their graft selection. Only 12.7% would choose another graft if in the situation again. Of these patients, 63.3% would change from an autograft to allograft.


CONCLUSIONS
This study suggests that the most important factor for a patient choosing a graft for ACL reconstruction is physician recommendation. Our study has shown an increasing trend in our group toward the use of allograft materials for ACL reconstruction (63.3% of all graft materials selected). Of the individuals who were dissatisfied with their graft, 63% who originally chose autograft would choose allograft as a source in the future.


METHODS
Level III, prognostic case-control study.
Cohen
Steven B
SB
Rothman Institute, Philadelphia, Pennsylvania 19107, USA.
Yucha
David T
DT
Ciccotti
Michael C
MC
Goldstein
Daniel T
DT
Ciccotti
Matthew A
MA
Ciccotti
Michael G
MG
D015502:Absorptiometry, Photon; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D001696:Biomechanical Phenomena; D001863:Bone Screws; D002102:Cadaver; D004867:Equipment Design; D006801:Humans; D018579:Patient Selection; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D053831:Surgical Fixation Devices / Q000706:statistics & numerical data*; D013977:Tibia / Q000601:surgery*; D016474:Weight-Bearing