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.
Design: Descriptive cross-sectional survey.
Setting: Canada.
Participants: A random sample of 50% of Canadian orthopedic surgeons registered with the Canadian Orthopaedic Association (COA).
Main outcome measure: 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.