General Perceptions of Operative Versus Nonoperative Management of ACL Tears Using an Online Survey Platform

OBJECTIVES: This study aimed to evaluate the general population's perceptions of conservative treatment compared with surgical intervention for anterior cruciate ligament (ACL) tears. DESIGN: Cross-sectional survey study analyzing public opinions on ACL treatment approaches. SETTING: A 44-question survey constructed by the current authors. PARTICIPANTS: Participants were recruited from a web-based survey that was developed using Amazon Mechanical Turk (MTurk), a validated online crowd source platform. This study recruited adult participants ≥18 years of age and those residing in the United States. MAIN OUTCOME MEASURES: Demographic data, prior exposure to ACL injuries, and preferences for surgical versus nonsurgical treatment. INDEPENDENT VARIABLES: Demographic, educational, vocational, and prior surgical variables were collected. RESULTSINTOTAL,: 529 participants were included with mean age of 43.4 ± 12.5 years. A total of 38.5% of respondents preferred surgical treatment, while 61.5% chose nonoperative care. Among competitive athletes, 73.6% favored surgery compared with only 25.7% of nonathletes who preferred operative treatment (P < 0.01). Physician recommendations significantly influenced decisions, with 76.7% of participants stating they would follow their surgeon's advice if they initially preferred surgery but were recommended to surgery by their surgeon. The main reasons for choosing surgery were concerns for long-term joint health and the desire to return to high-level activity. CONCLUSIONS: Public perception of ACL injury management is influenced by athletic participation, trust in medical professionals, and concerns about surgery. These findings highlight the need for enhanced patient education and shared decision making to align treatment choices with individual goals and clinical outcomes. Future research should explore targeted educational interventions and their impact on treatment preferences, particularly in younger, high-risk populations.