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Early postoperative practices following anterior cruciate ligament reconstruction in France - 30/11/21

Doi : 10.1016/j.otsr.2021.103065 
Hasan Basri Sezer a, Thibaut Noailles b, Cécile Toanen c, Nicolas Lefèvre a, Yoann Bohu a, Jean-Marie Fayard d, Alexandre Hardy a,

the Francophone Arthroscopy Society (SFA)e

a Clinique du Sport Paris V, 36, Boulevard Saint Marcel, 75005 Paris, France 
b Département de Chirurgie Orthopédique, Polyclinique de Bordeaux Nord, 15, Rue Claude-Boucher, 33000 Bordeaux, France 
c Service de Chirurgie Orthopédique et Traumatologique, CHD Vendée, Boulevard Stéphane Moreau, 85925 La Roche-Sur-Yon, France 
d Centre Orthopedique Santy, 24, Rue Paul Santy, 69008 Lyon, France 
e 15, Rue Ampère, 92500 Rueil Malmaison, France 

Corresponding author.

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Abstract

Introduction

The early postoperative period after anterior cruciate ligament reconstruction (ACL) is critical for optimal functional recovery. Despite an abundance of literature, there is no consensus regarding good practices. This period is often under-considered by orthopedic surgeons. The aim of this study was to identify early postoperative practices after ACL reconstruction in France.

Hypothesis

The hypothesis was that there was a discrepancy between validated data in the literature and the current practices of orthopedic surgeons in France.

Material and methods

In 2019, a questionnaire was sent to all the members of the French Arthroscopy Society to investigate their postoperative practices after ACL reconstruction. Two hundred sixty-nine members responded. Surgeons were divided into two groups of experienced (n=137) and less experienced (n=132) surgeons, according to the number of ACL reconstructions performed per year (<or50/year). Outpatient management, effusion prevention measures, and rehabilitation instructions and goals were collected. Overall responses were analyzed after multiple linear logistic regression and the responses of the two groups were compared.

Results

ACL reconstruction was performed as an outpatient procedure in 72.9% of cases. This rate increased with surgical experience (p=0.009×10−3). Among measures to prevent effusion, cryotherapy was recommended in 97.8% of cases. The experienced group more often used compressive cryotherapy devices (p=0.004). Rehabilitation was started immediately in 75.5% of cases, with as main objective recovery of full extension (89.6%). Weight-bearing was allowed in 98.5% of cases and a brace was prescribed in 69.9% of cases. In the experienced group, braces were less frequent (p=0.02) and self-rehabilitation was preferred (p=0.0006).

Conclusion

Early postoperative practices after ACL reconstruction in France are related to surgical experience. The greater the surgical experience, the greater the role of joint effusion prevention and self-rehabilitation. Despite recommendations in the literature, a quarter of the French orthopedic surgeons who responded to this survey did not perform this procedure on an outpatient basis and more than two-thirds prescribed braces.

Level of Evidence

IV.

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Keywords : Anterior cruciate ligament reconstruction, Clinical practice, Early rehabilitation, Questionnaire study


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© 2021  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 107 - N° 8S

Artículo 103065- décembre 2021 Regresar al número
Artículo precedente Artículo precedente
  • Anterior cruciate ligament reconstruction in the over-50s. A prospective comparative study between surgical and functional treatment
  • Matthieu Ehlinger, Jean-Claude Panisset, David Dejour, Jean-Francois Gonzalez, Régis Paihle, Henri Favreau, Matthieu Ollivier, Sébastien Lustig, the Francophone Arthroscopy Society (SFA)
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  • Erwan Pansard, Mathieu Thaunat, Marie Vigan, Michael Wettstein, Xavier Flecher, Francophone Arthroscopy Society (SFA)

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