Matthew J. Matava,Daniel R. Howard,Landon Polakof,Robert H. Brophy

Background:

Relatively little information exists regarding the public’s perception of anterior cruciate ligament (ACL) injuries and their treatment. The objective of this study was to test the hypothesis that the public’s understanding of ACL surgery may be incorrect with regard to various aspects of this procedure and to identify issues to emphasize in patient education.

Methods:

This study utilized a forty-three-question survey designed to measure an individual’s knowledge base and perception of ACL reconstruction with regard to the anatomy, function, indications, operative technique, risks, recovery time, and overall benefits of the procedure. Eligible individuals were between fifteen and sixty years of age. Study participants were recruited from an academic orthopaedic sports medicine clinic, a collegiate athletic training room, and various public venues.

Results:

A total of 210 individuals (106 men and 104 women) with a mean age of thirty were surveyed. Educational level of the respondents varied widely. Twenty-seven percent of the respondents were employed in a health-care setting. Sixty-five percent of the respondents rated their ACL knowledge level as “little” or “none.” Participants’ self-perception of ACL knowledge was highly correlated with their survey scores on questions with a specific correct answer (p < 0.001). Almost one-third thought that surgical treatment involved repair of the torn ligament rather than reconstruction. Over half (56%) of the respondents preferred an autograft for ligament reconstruction, compared with 4% who preferred an allograft. The ability to return to sports after ACL surgery was the most important concern, followed by the risk of developing osteoarthritis.

Conclusions:

There is wide variability in the lay public’s knowledge level of ACL injuries; a substantial number of misguided perceptions were identified. Return to sports and risk for future osteoarthritis following ACL surgery appear to be the most important factors to the lay public. Focusing educational efforts on areas of knowledge deficits may be particularly important for patients of physicians who treat ACL injuries.