In an attempt to quantify the current standards in surgical procedures and rehabilitation protocols utilized to treat patients with anterior cruciate ligament (ACL)-deficient knees, a 19-question survey was sent to members of the Hawaii Orthopedic Association. The findings indicated that only 54% (30/56) of the respondents were performing ACL reconstructions, of which 87% (26/30) were performing an intra-articular procedure and none were performing extra-articular procedures exclusively. The findings further indicate that 80% (24/30) of the 30 respondents performing ACL reconstructions were using an arthroscopically assisted, bone-tendon-bone autograft procedure. However, in marked contrast to the uniformity that existed concerning the surgical procedure, there was a drastic difference in the rehabilitation protocols and procedures that were recommended postoperatively. The most apparent differences in rehabilitation protocols existed in the utilization and initiation of open versus closed type kinetic chain exercises and activities.
Michael R. McCarthy is with McCarthy Orthopedic Rehabilitation and Sports Medicine, 415 A Ulumiu St., Kailua, HI 96734. Barton P. Buxton is with the Health, Physical Education and Recreation Department and the John A. Bums Schools of Medicine, University of Hawaii at Manoa. W. Douglas. B. Hiller and James R. Doyle are with the John A. Burns Schools of Medicine, University of Hawaii at Manoa. Denis Yamada is with Pali Momi Medical Center, Aiea, HI 96701. Direct correspondence to Barton P. Buxton, University of Hawaii at Manoa, 1337 Lower Campus Rd., Honolulu,. HI 96822.