John Nyland, EdD, PT, ATC; David N. M. Caborn, MD; Darren L. Johnson, MD; John Moore, MS, ATC; Keith Slone, MS
Patellar Tendon ACL Reconstruction and Rehabilitation Practices and Opinions (Autograft versus Allograft): Orthopaedic Sports Medicine Fellowship Program Survey
ABSTRACT: We wanted to determine the bonepatellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction practices of accredited orthopaedic sports medicine fellowship programs and their opinions about whether differences should exist in rehabilitation protocol, bracing, and timing of release to cutting/agility sports between autogeneic and allogeneic grafts. Our survey showed most programs did 51 to 100 BPTB ACL reconstructions during the 12 months before survey completion. Standard rehabilitation protocols were used without differences based on BPTB graft type or fixation concerns. Programs were equally divided regarding whether BPTB graft type should be a timing of release to cutting/agility sports factor. Programs were almost equally divided regarding routinely prescribed derotation braces. More programs used autograft rather than allograft BPTB tissue for ACL reconstruction, without rehabilitation protocol differences based on graft type or fixation concerns. Conflicting results regarding protocol and timing of release to cutting/agility sports indicate that several factors may contribute to the clinical decision-making process. Equivocal results regarding derotation brace prescription raises concerns regarding their necessity.