title: Patients' attitudes and factors in their selection of grafts for anterior cruciate ligament reconstruction.
abstract: Surgeon recommendation is the primary influence for patients choosing a graft for their ACL reconstruction. However, it is unknown if demographic factors also play a role. We hypothesize that education, age, and living in an urban setting may influence a patient's graft choice. Patients who had an ACL reconstruction from 2005 to 2009 were identified retrospectively, and received a written survey on their demographics and the factors affecting graft choice. They also rated their perception of those factors based on a Likert scale. Out of 471 surveys distributed, 151 responses were received. The mean follow-up time was 19 months (range, 1 to 63 months). Autograft was used in 57%. Surgeon recommendation was the primary factor in graft choice (63%). 87.4% of patients felt they made the right choice; only 4.6% would have picked a different graft if they could choose over again. More than half (51.7%) of patients did significant personal research, and used mostly medical websites (41.1%). 67.6% of patients were not adverse to allograft. The primary factor for patients in graft choice was surgeon recommendation. Still, the use of medical websites was widespread, and patients in an urban environment were less likely to rely solely on their surgeon's recommendation. Older patients were more concerned with autograft donor site morbidity, and patients with a higher level of education were less averse to allograft.
authors.affiliation: Department of Orthopaedic Surgery, Sports Medicine and Shoulder Surgery, University of California, San Francisco, United States.
authors.forename: Sunny C
authors.initials: SC
authors.lastname: Cheung
authors.forename: Christina R
authors.initials: CR
authors.lastname: Allen
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gallo
authors.forename: C Benjamin
authors.initials: CB
authors.lastname: Ma
authors.forename: Brian T
authors.initials: BT
authors.lastname: Feeley
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000523:psychology / Q000601:surgery; D008297:Male; D010342:Patient Acceptance of Health Care; D010819:Physician's Role; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous