Management after acute injury of the anterior cruciate ligament (ACL). Part 3: Recommendation on surgical treatment

Author:

Häner Martin1ORCID,Stoffels Thomas2,Guenther Daniel3,Pfeiffer Thomas3,Imhoff Andreas4,Herbort Mirco5,Stein Thomas67,Schoepp Christian8,Akoto Ralph910,Höher Jürgen11,Scheffler Sven12,Stöhr Amelie5,Mehl Julian4,Niederer Daniel1314,Jung Tobias15,Kittl Christoph16,Eberle Christian17,Vernacchia Cara1819,Ellermann Andree17,Braun Philipp‐Johannes20,Krause Matthias21,Mengis Natalie1722,Müller Peter E.23,Best Raymond2425,Achtnich Andrea4,Petersen Wolf1

Affiliation:

1. Department of Orthopedics, Sportsclinic Berlin Martin Luther Hospital Berlin Germany

2. OC Stadtmitte Berlin Germany

3. Department of Orthopaedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center Witten/Herdecke University Cologne Germany

4. Department for Orthopedic Sports Medicine Technical University Munich Munich Germany

5. OCM Clinic Munich Munich Germany

6. SPORTHOLOGICUM® Frankfurt am Main Frankfurt Germany

7. Department of Sports Medicine Goethe University Frankfurt Frankfurt Germany

8. Department of Arthroscopic Surgery Sports Traumatology and Sports Medicine, BG Klinikum Duisburg Germany

9. Department of Trauma and Orthopaedic Surgery, Sports Traumatology BG Hospital Hamburg Hamburg Germany

10. Department of Orthopaedics, Trauma Surgery and Sports Medicine, Cologne‐Merheim Medical Center University of Witten/Herdecke Cologne Germany

11. Sportsclinic Cologne Köln Germany

12. Sporthopaedicum Berlin Berlin Germany

13. Department of Movement and Training Science, Faculty of Humanities and Social Sciences, Institute of Sport Science University of Wuppertal Wuppertal Germany

14. Institute of Occupational, Social and Environmental Medicine Goethe University Frankfurt Frankfurt German

15. Center for Musculoskeletal Surgery, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany

16. Department of Trauma, Hand and Reconstructive Surgery Westphalian Wilhelms University Muenster Muenster Germany

17. ARCUS Sports Clinic Pforzheim Germany

18. Department of Physical Medicine & Rehabilitation Shirley Ryan Ability Lab Chicago Illinois USA

19. McGaw, Feinberg School of Medicine Northwestern University Chicago Illinois USA

20. Department of Trauma and Orthopaedic Surger BG Hospital Unfallkrankenhaus Berlin Germany

21. Department of Trauma and Orthopaedic Surgery University Medical Center Hamburg‐Eppendorf Hamburg Germany

22. KSA Aarau/Spital Zofingen Zofingen Switzerland

23. Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital LMU Munich Munich Germany

24. Department of Orthopaedic and Sports Trauma Surgery Sportklinik Stuttgart Stuttgart Germany

25. Department of Sports Medicine and Orthopaedics University of Tuebingen Tuebingen Germany

Abstract

AbstractPurposeThe aim of this consensus project was to give recommendations regarding surgical treatment of the anterior cruciate ligament (ACL) injured patient.MethodsFor this consensus process, an expert, steering and rating group was formed. In an initial online meeting, the steering group, together with the expert group, formed various key topic complexes for which multiple questions were formulated. For each key topic, a structured literature search was performed by the steering group. The results of the literature review were sent to the rating group with the option to give anonymous comments until a final consensus voting was performed. Sufficient consensus was defined as 80% agreement.ResultsDuring this consensus process, 30 topics regarding the surgical management and technique of ACL reconstruction were identified. The literature search for each key question resulted in 30 final statements. Of these 30 final statements, all achieved consensus.ConclusionsThis consensus process has shown that surgical treatment of ACL injury is a complex process. Various surgical factors influence patient outcomes. The proposed treatment algorithm can be used as a decision aid for the surgeon.Level of EvidenceLevel V.

Publisher

Wiley

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