Beliefs and attitudes of members of the American Academy of Orthopaedic Surgeons regarding the treatment of anterior cruciate XXXX .

@entity1 @entity4040 @entity1347 @entity1887 @entity158 @entity130
PURPOSE: The purpose of the study was to quantify the amount of agreement among orthopaedic surgeons regarding the natural history of the anterior cruciate ligament (ACL)-deficient knee, surgery, and rehabilitation, and the treatment of these @entity1 . TYPE OF STUDY: Physician mail survey. METHODS: Orthopaedic surgeons were randomly selected from the American Academy of Orthopaedic Surgeons (AAOS) directory. Only individuals who treated or referred @entity1887 @entity1 for treatment within the past year were asked to complete the 3-page survey. The survey included 25 questions regarding clinical opinion. Clinical agreement was present when 80% or more of the surgeons agreed on the same response option. RESULTS: The total number of surgeons who responded to the survey was 397 (response rate, 54.8%) and the number who had treated or referred @entity1887 @entity1 in the past year was 261. Among surgeons who completed the questionnaire, the response rates to the individual questions ranged from 92% to 100%. The mean response rate for all questions was 97.4%. The mean age of the surgeons was 48.4 years, and 35.8% considered their practice to be a subspecialty in sports medicine or knee surgery. For 12 questions (48%), there was clinical disagreement among the surgeons. Surgical volume was associated with clinical opinion for 16 of 25 questions (P < or =.05). CONCLUSIONS: Significant variation is seen in clinical opinion and decision-making regarding @entity130 among members of the AAOS, particularly regarding whether @entity1347 @entity1 can participate in all recreational sports activities, that ACL reconstruction reduces the rate of @entity4040 , and on the use of braces in the postoperative period. Additionally, surgeons disagreed on the effect of 4 @entity1 characteristics (age over 40, presence of @entity158 , irreparable meniscal tear, @entity130 ) on the decision to perform surgery. Areas of significant clinical uncertainty should be the focus of future research and medical education for orthopaedic surgeons who treat @entity130 .
