Web-based survey results: surgeon practice patterns in Italy regarding anterior cruciate ligament reconstruction and rehabilitation

Knee Surg Sports Traumatol Arthrosc. 2017 Aug;25(8):2520-2527. doi: 10.1007/s00167-016-4007-3. Epub 2016 Feb 1.


Purpose: The aim of this study was to report Italian orthopaedic surgeons' management of choice for ACL reconstruction and rehabilitation, and to compare surgical applications and rehabilitation approaches of Italian surgeons to the current approaches of "ACL Study Group". A secondary purpose was to compare the preferences of subgroup based on graft choice, surgical techniques and experience.

Methods: A web-based survey was developed to investigate the attitudes of members of a national association specialized in sports traumatology and knee surgery (SIGASCOT) regarding surgical techniques, routine post-operative applications, rehabilitation approaches and starting time of specific activities and exercises following ACL reconstruction.

Results: The response rate was 17 % (131 questionnaires). The most popular graft type was hamstring tendon (81 % in male patients, and 91 % in female patients). The rate of continuous passive motion use was 55 %. Half surgeons routinely used a brace (49 %), usually a hinged brace. In total, 33.0 % of surgeons allowed patients to load the operated knee as much as tolerated within the first 2 weeks. Fifty-nine per cent of surgeons did not limit full flexion within the first 2 weeks. Most surgeons advise to wait until 4 months or more (97 %) for return to sports not requiring contact, and 6 months or more for full-contact sport (86 %).

Conclusions: This survey demonstrates clear trends in the practice of ACL reconstruction and rehabilitation in Italy. The data obtained from the SIGASCOT members revealed a more conservative approach when compared to the current approaches of "ACL Study Group".

Level of evidence: Cross-sectional survey, Level III.

Keywords: Anterior cruciate ligament; Italy; Rehabilitation; Survey.

MeSH terms

  • Anterior Cruciate Ligament Injuries / rehabilitation*
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Braces*
  • Cross-Sectional Studies
  • Female
  • Hamstring Tendons / transplantation*
  • Humans
  • Internet
  • Italy
  • Male
  • Orthopedic Surgeons
  • Patellar Ligament / transplantation*
  • Practice Patterns, Physicians'*
  • Return to Sport*
  • Surveys and Questionnaires