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Patient Perception of Autograft Options in ACL Reconstruction Using a Validated Online Survey Marketplace
Robert S Dean1, Tanner Hafen1, Ryan McNassor1
1Corewell Health Orthopedics, Royal Oak, Michigan, USA.
Background:
Anterior cruciate ligament reconstruction (ACLR) is a common surgery performed with a variety of different autograft options. While there is much research that highlights the benefits and drawbacks of each of these options, there is little known about the knowledge of the general population regarding these options and how patient education may influence their choice.
Purpose:
To evaluate the general population's perception of commonly utilized autografts in ACLR.
Study Design:
Cross-sectional study.
Methods:
Using an online marketplace, a random selection of participants from the general population were asked about demographic data and preferences for autograft type. All respondents then participated in a survey sent in August 2024, reviewed information from an evidence-based sheet, and completed a posteducation test. Participants were again asked about graft preferences. Participants were asked whether they would change their preference based on surgeon recommendation and what factors influenced their decisions. Statistical analysis was performed using Shapiro-Wilks test to determine normality, and Student paired t test was used for comparison.
Results:
There were 491 participants with a mean age of 39.9 (range, 19-72). Before participant education regarding graft types, 19.3% preferred bone-patellar tendon-bone (BPTB), 18.7% preferred quadriceps tendon (QT), 12.6% preferred hamstring tendon (HT), and 53.4% had no preference. Following education, a significantly greater number of participants chose each graft type; 37.7% (P < .01) preferred BPTB, 21.6% (P < .01) preferred QT, and 13.8% (P < .01) preferred HT. Significantly fewer participants had no preference (26.9%; P < .01). Among the most important factors in patient preference was surgeon preference (n = 357; 72.7%), as 424 (86.4%) participants said they would switch their graft preference if their surgeon recommended it.
Conclusion:
The findings of this study imply that informed patients can participate in medical decision making with respect to their graft choices in ACLR and that providing educational information can help surgeons and patients work together to optimize patient care.
