What influences patient decision making after anterior cruciate ligament injury in Australia; an internet survey

Abstract

Objectives We aimed to understand what influences patient decision-making after ACL rupture. Methods A survey was carried out online, targeting individuals who had experienced an ACL rupture injury. Outcomes included person(s) who influenced patient decision-making, sources of information used to assist the decision-making process and the main reasons that informed their decision to undergo ACL reconstruction surgery or rehabilitation only. Results 174 participants (mean age 29.8 years, 53% male) met inclusion criteria, of which 144 (80%) underwent ACL reconstructive surgery and 20 (11%) completed rehabilitation alone. The most common people who influenced decisions were the orthopaedic surgeon for those who had surgery (n = 103, 84%) and the physiotherapist for those who underwent rehabilitation alone (n = 12, 75%). The most common reason for choosing ACL reconstructive surgery was to be able to return to sport (n = 100, 82%), and for rehabilitation alone, it was because they believed it would give the same result as surgical management (n = 12, 75%). Of those who had surgery, 56% (n = 67) received limited to no information on non-surgical management options. Conclusions Many people in Australia undergo surgical reconstruction for their ACL, with limited awareness of trialling rehabilitation alone. The most influential people in a patient’s treatment decision after ACL rupture in Australia are the orthopaedic surgeon and physiotherapist.