Brief Article
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World J Orthop. Oct 18, 2013; 4(4): 309-315
Published online Oct 18, 2013. doi: 10.5312/wjo.v4.i4.309
Current practice variations in the management of anterior cruciate ligament injuries in Croatia
Alan Mahnik, Silvija Mahnik, Damjan Dimnjakovic, Stjepan Curic, Tomislav Smoljanovic, Ivan Bojanic
Alan Mahnik, Silvija Mahnik, Damjan Dimnjakovic, Tomislav Smoljanovic, Ivan Bojanic, Department of Orthopaedic Surgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Stjepan Curic, Institute of Public Health County Krapinsko-zagorska, Zlatar 49250, Croatia
Author contributions: Mahnik A, Smoljanovic T and Bojanić I contributed to the conception and design of the research; Mahink A, Mahnik S, Dimnjakovic D and Curic S were responsible for the majority of the fieldwork, and contributed to acquisition of the data; Mahink A and Mahnik S performed the most of the analysis and interpretation of the data; Mahnik A, Mahnik S, Dimnjakovic D, Curic S wrote a draft of the manuscript; Smoljanovic T and Bojanic I performed critical revision of the manuscript for important intellectual content; all the authors approved the submitted version of the manuscript.
Correspondence to: Tomislav Smoljanovic, MD, PhD, Department of Orthopaedic Surgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Salata 7, 10000 Zagreb, Croatia. drsmoljanovic@yahoo.com
Telephone: +385-1-2368911 Fax: +385-1-2368937
Received: March 4, 2013
Revised: May 18, 2013
Accepted: June 18, 2013
Published online: October 18, 2013
Abstract

AIM: To investigate current preferences and opinions on the diagnosis, treatment and rehabilitation of patients with anterior cruciate ligament (ACL) injury in Croatia.

METHODS: The survey was conducted using a questionnaire which was sent by e-mail to all 189 members of the Croatian Orthopaedic and Traumatology Association. Only respondents who had performed at least one ACL reconstruction during 2011 were asked to fill out the questionnaire.

RESULTS: Thirty nine surgeons responded to the survey. Nearly all participants (95%) used semitendinosus/gracilis tendon autograft for reconstruction and only 5% used bone-patellar tendon-bone autograft. No other graft type had been used. The accessory anteromedial portal was preferred over the transtibial approach (67% vs 33%). Suspensory fixation was the most common graft fixation method (62%) for the femoral side, followed by the cross-pin (33%) and bioabsorbable interference screw (5%). Almost all respondents (97%) used a bioabsorbable interference screw for tibial side graft fixation.

CONCLUSION: The results show that ACL reconstruction surgery in Croatia is in step with the recommendations from latest world literature.

Keywords: Anterior cruciate ligament, Survey, Knee, Surgery, Reconstruction

Core tip: The anterior cruciate ligament (ACL) is the prime static stabilizer against anterior translation of the tibia on the femur. We conducted a survey of members of the Croatian Orthopaedics and Traumatology Association to gain an understanding of preferences and opinions regarding the treatment of ACL injuries. Our findings are compared with those of previous surveys found in the literature to highlight temporal shifts and geographic differences in opinion.