Clin Orthop Surg.  2010 Jun;2(2):69-75. 10.4055/cios.2010.2.2.69.

Factors Affecting Patients' Graft Choice in Anterior Cruciate Ligament Reconstruction

• Koh HS
• In Y
• Kong CG
• Won HY
• Kim KH
• Lee JH

• KMID: 1719332
• DOI: http://doi.org/10.4055/cios.2010.2.2.69

Abstract

BACKGROUND
Multiple studies have reported that allografts are acceptable alternatives to autografts for anterior cruciate ligament (ACL) reconstructions. Our clinical practice allows patient involvement in graft decision-making. This study examined the patients' preference for graft selection and the factors affecting their decision.
METHODS
Patients scheduled to undergo an ACL reconstruction surgery (n = 129) at a university medical center in Korea were enrolled in this study. Information leaflets with graft descriptions were provided prior to hospital admission, and the patients were allowed to choose one of two surgical graft types. The patients were asked to complete a questionnaire that reflected their decision-making processes, and the patients' trends and factors affecting their choice of graft were analyzed based on their responses.
RESULTS
Most patients (54.3%) selected autografts for the ACL reconstruction. The surgeon's explanation was the most important factor affecting the final patient decision followed by the information derived from Internet searches. Patients who derived the majority of their understanding of the graft types from the Internet chose allografts at significantly higher rates.
CONCLUSIONS
Patient graft selection is a reasonable way of designating the type of surgical procedure. Most patients selected autografts for their ACL reconstruction. However, patients who performed significant Internet-based research tended to prefer allografts.

Keyword

Anterior cruciate ligament; Reconstruction; Graft; Patient preference

MeSH Terms

Adolescent
Adult
Anterior Cruciate Ligament/*surgery
Choice Behavior
Female
Humans
Internet
Male
Middle Aged
Patient Education as Topic
*Patient Preference
Questionnaires
Reconstructive Surgical Procedures
Tendons/*transplantation
*Transplantation, Autologous
*Transplantation, Homologous
Young Adult

Figure

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  Fig. 1 Patients received an information leaflet containing general ACL graft information with descriptions of a hamstring tendon autograft and tibialis anterior tendon allograft (English version of leaflet).

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  Fig. 2 The patients completed an 11-item questionnaire discussing their graft decisions on hospital admission for surgery (English version of the questionnaire).

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  Fig. 3 Information sources affecting the choice of graft in all patients.

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  Fig. 4 Information sources affecting the choice of graft in the autograft and allograft groups. The proportions of leaflet and internet (*) between the autograft and allograft groups were significantly different (p = 0.003, p = 0.008, respectively).

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