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INTRODUCTION/OBJECTIVES: Anterior cruciate ligament reconstruction (ACLR) has been a highly active area in orthopaedic research in the past several decades, which has been associated with changing surgical practices. The purpose of this study is to present survey data over 25 years from members of the ACL Study Group (ACL SG) and to evaluate trends in expert opinion over time. METHODS: From 1998 to 2023, an electronic questionnaire was distributed to members of the ACL SG every two years. The questions explore ACLR topics including graft preferences, tunnel drilling techniques, graft fixation techniques, role for ACL repair, meniscal repair aggressiveness, return to sport timelines, and osteoarthritis risk as it relates to ACLR. RESULTS: Between 1998 and 2023, preferences for graft choice for primary ACLR showed a trend toward decreasing bone-patellar tendon-bone (BTB) autograft usage, increasing hamstring autograft usage, low allograft usage, and a recent rise in quadriceps autograft usage. For revision ACLR, hamstring autograft usage initially predominated but sharply declined in 2016, concurrent with a sharp rise in BTB autograft use and a steadier rise in quadriceps autograft usage. Anteromedial femoral tunnel drilling technique showed a dominant and increasing utilization, antegrade full-tunnel tibial drilling consistently predominated, metallic interference screw use has declined with a rise in cortical suspensory constructs for femoral fixation, and absorbable interference screws use for tibial fixation has been the most common technique. There has been a trend of increasing aggressiveness for concurrent extra-articular augmentation and meniscus repair over time, and a recent trend toward 9-month return to cutting sport timelines compared to 6 months. CONCLUSION: This study reveals trends in opinions and preferences of the ACL SG over the past 25 years, which dynamically both drive and respond to important scientific evidence in ACLR. LEVEL OF EVIDENCE: Level V, Expert Opinion.
Schroeder et al. (Thu,) studied this question.