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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

Timing of permission to return to sport without restriction in Major League Soccer by team physicians.
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fig3-2325967114559892: Timing of permission to return to sport without restriction in Major League Soccer by team physicians.

Mentions: After an ACL tear, most surgeons perform reconstruction within 4 weeks (48% within 2 weeks, 33% at 2-4 weeks) (Figure 2). 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 BPTB was the most common preferred graft choice. Ranking of top 5 graft choices reiterated BPTB as the most preferred choice and the autograft quadriceps tendon as the least preferred choice. 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 CPM (64%) or functional bracing (68%). Most surgeons permitted return to sport without restrictions at 6 to 8 months following surgery (82%) (Figure 3). Fifty-nine percent of surgeons felt that at least 80% of players are not only able to return to sport following ACL reconstruction but do so at the preinjury level or higher.


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)

Timing of permission to return to sport without restriction in Major League Soccer by team physicians.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

fig3-2325967114559892: Timing of permission to return to sport without restriction in Major League Soccer by team physicians.
Mentions: After an ACL tear, most surgeons perform reconstruction within 4 weeks (48% within 2 weeks, 33% at 2-4 weeks) (Figure 2). 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 BPTB was the most common preferred graft choice. Ranking of top 5 graft choices reiterated BPTB as the most preferred choice and the autograft quadriceps tendon as the least preferred choice. 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 CPM (64%) or functional bracing (68%). Most surgeons permitted return to sport without restrictions at 6 to 8 months following surgery (82%) (Figure 3). Fifty-nine percent of surgeons felt that at least 80% of players are not only able to return to sport following ACL reconstruction but do so at the preinjury level or higher.

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