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Treatment of Anterior Cruciate Ligament Injuries by Major League Soccer Team Physicians.

Farber J, Harris JD, Kolstad K, McCulloch PC - Orthop J Sports Med (2014)

Bottom Line: Most surgeons did not recommend postoperative continuous passive motion (64%) or functional bracing (68%).This article successfully describes current management of ACL injuries among MLS team orthopaedic surgeons.The preference for single-bundle BPTB autograft is similar to published data in the National Football League and National Basketball Association.

View Article: PubMed Central - PubMed

Affiliation: Southwest Michigan Center for Orthopaedics and Sports Medicine, Saint Joseph, Michigan, USA.

ABSTRACT

Background: The treatment and rehabilitation procedures of anterior cruciate ligament (ACL) injuries in elite soccer players are controversial. Points of debate include surgical timing, technique, graft choice, rehabilitation, and return-to-sport criteria and timing.

Purpose: To identify practice preferences among current Major League Soccer (MLS) team orthopaedic surgeons for ACL injuries.

Study design: Cross-sectional study; Level of evidence, 4.

Methods: The survey was administered at the MLS team physician annual meeting in January 2013. At least 1 orthopaedic surgeon representative from each of the 19 clubs (16 from the United States, 3 from Canada) was in attendance. Teams with more than 1 affiliated orthopaedic surgeon were given an additional survey to be completed either at the meeting or returned via e-mail. Descriptive statistics, Wilcoxon Mann-Whitney (return-to-play parameters, running, and ball drills), and Fisher exact tests (graft selection, bracing, continuous passive motion) were applied to the various data sets from the survey responses.

Results: A 100% survey participation rate was achieved (22 team orthopaedic surgeons representing 19 MLS teams). A single-incision, arthroscopically assisted, single-bundle reconstruction was the most common technique (91%). Surgeons were split regarding femoral tunnel drilling (50% transtibial, 46% accessory medial). Autograft bone-patellar tendon-bone (BPTB) was the most common preferred graft choice (68%). The biggest concerns about BPTB autograft and hamstring autograft were anterior knee pain (76%) and hamstring weakness (46%), respectively. Most surgeons did not recommend postoperative continuous passive motion (64%) or functional bracing (68%). Most surgeons permitted return to sport without restrictions at 6 to 8 months following surgery (82%). Surgeons who routinely used functional bracing after ACL surgery more frequently used hamstring autograft than those who used BPTB autograft (P = .04).

Conclusion: This article successfully describes current management of ACL injuries among MLS team orthopaedic surgeons. The preference for single-bundle BPTB autograft is similar to published data in the National Football League and National Basketball Association.

No MeSH data available.


Related in: MedlinePlus

Anterior cruciate ligament injuries in Major League Soccer (MLS): current treatment trends among team physicians. For the purposes of this survey, elite soccer player is defined as a male college, semiprofessional, MLS developmental team member, or professional soccer player. ACL, anterior cruciate ligament; BTB, bone–patellar tendon–bone; CPM, continuous passive motion.
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fig1-2325967114559892: Anterior cruciate ligament injuries in Major League Soccer (MLS): current treatment trends among team physicians. For the purposes of this survey, elite soccer player is defined as a male college, semiprofessional, MLS developmental team member, or professional soccer player. ACL, anterior cruciate ligament; BTB, bone–patellar tendon–bone; CPM, continuous passive motion.

Mentions: The MLS ACL treatment survey (Figure 1) focused on several aspects of timing, surgical technique, graft choice, bracing, rehabilitation, and return to play in elite soccer players. The survey consisted of 19 questions, several of which were adapted from a previously published survey completed by NFL team physicians regarding American professional football players.3 The survey was administered at the annual meeting of MLS team physicians in January 2013. The MLS team physician society approved the survey. Any responses not collected by the end of the meeting were obtained via e-mail. An “elite soccer player” was defined as a male collegiate, semiprofessional, MLS developmental team member, or MLS professional soccer player.


Treatment of Anterior Cruciate Ligament Injuries by Major League Soccer Team Physicians.

Farber J, Harris JD, Kolstad K, McCulloch PC - Orthop J Sports Med (2014)

Anterior cruciate ligament injuries in Major League Soccer (MLS): current treatment trends among team physicians. For the purposes of this survey, elite soccer player is defined as a male college, semiprofessional, MLS developmental team member, or professional soccer player. ACL, anterior cruciate ligament; BTB, bone–patellar tendon–bone; CPM, continuous passive motion.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555558&req=5

fig1-2325967114559892: Anterior cruciate ligament injuries in Major League Soccer (MLS): current treatment trends among team physicians. For the purposes of this survey, elite soccer player is defined as a male college, semiprofessional, MLS developmental team member, or professional soccer player. ACL, anterior cruciate ligament; BTB, bone–patellar tendon–bone; CPM, continuous passive motion.
Mentions: The MLS ACL treatment survey (Figure 1) focused on several aspects of timing, surgical technique, graft choice, bracing, rehabilitation, and return to play in elite soccer players. The survey consisted of 19 questions, several of which were adapted from a previously published survey completed by NFL team physicians regarding American professional football players.3 The survey was administered at the annual meeting of MLS team physicians in January 2013. The MLS team physician society approved the survey. Any responses not collected by the end of the meeting were obtained via e-mail. An “elite soccer player” was defined as a male collegiate, semiprofessional, MLS developmental team member, or MLS professional soccer player.

Bottom Line: Most surgeons did not recommend postoperative continuous passive motion (64%) or functional bracing (68%).This article successfully describes current management of ACL injuries among MLS team orthopaedic surgeons.The preference for single-bundle BPTB autograft is similar to published data in the National Football League and National Basketball Association.

View Article: PubMed Central - PubMed

Affiliation: Southwest Michigan Center for Orthopaedics and Sports Medicine, Saint Joseph, Michigan, USA.

ABSTRACT

Background: The treatment and rehabilitation procedures of anterior cruciate ligament (ACL) injuries in elite soccer players are controversial. Points of debate include surgical timing, technique, graft choice, rehabilitation, and return-to-sport criteria and timing.

Purpose: To identify practice preferences among current Major League Soccer (MLS) team orthopaedic surgeons for ACL injuries.

Study design: Cross-sectional study; Level of evidence, 4.

Methods: The survey was administered at the MLS team physician annual meeting in January 2013. At least 1 orthopaedic surgeon representative from each of the 19 clubs (16 from the United States, 3 from Canada) was in attendance. Teams with more than 1 affiliated orthopaedic surgeon were given an additional survey to be completed either at the meeting or returned via e-mail. Descriptive statistics, Wilcoxon Mann-Whitney (return-to-play parameters, running, and ball drills), and Fisher exact tests (graft selection, bracing, continuous passive motion) were applied to the various data sets from the survey responses.

Results: A 100% survey participation rate was achieved (22 team orthopaedic surgeons representing 19 MLS teams). A single-incision, arthroscopically assisted, single-bundle reconstruction was the most common technique (91%). Surgeons were split regarding femoral tunnel drilling (50% transtibial, 46% accessory medial). Autograft bone-patellar tendon-bone (BPTB) was the most common preferred graft choice (68%). The biggest concerns about BPTB autograft and hamstring autograft were anterior knee pain (76%) and hamstring weakness (46%), respectively. Most surgeons did not recommend postoperative continuous passive motion (64%) or functional bracing (68%). Most surgeons permitted return to sport without restrictions at 6 to 8 months following surgery (82%). Surgeons who routinely used functional bracing after ACL surgery more frequently used hamstring autograft than those who used BPTB autograft (P = .04).

Conclusion: This article successfully describes current management of ACL injuries among MLS team orthopaedic surgeons. The preference for single-bundle BPTB autograft is similar to published data in the National Football League and National Basketball Association.

No MeSH data available.


Related in: MedlinePlus