Academic Journal
Factors Influencing Consultant Knee Surgeons' Decision Making in Anterior Cruciate Ligament (ACL) Injury Management in Athletes: An International Delphi Study.
| Τίτλος: | Factors Influencing Consultant Knee Surgeons' Decision Making in Anterior Cruciate Ligament (ACL) Injury Management in Athletes: An International Delphi Study. |
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| Συγγραφείς: | Young G; Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, M15 6GX, UK., Dobbin N; Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, M15 6GX, UK.; Institute of Sport, Manchester Metropolitan University, Manchester, M15 6GX, UK., Jain N; Department of Orthopaedics, The Wilmslow Hospital, 52 Alderley Road, Wilmslow, SK9 1NY, UK., Thorpe C; Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, M15 6GX, UK. M.Thorpe@mmu.ac.uk.; Institute of Sport, Manchester Metropolitan University, Manchester, M15 6GX, UK. M.Thorpe@mmu.ac.uk. |
| Πηγή: | Sports medicine (Auckland, N.Z.) [Sports Med] 2026 Oct; Vol. 56 (10), pp. 2611-2623. Date of Electronic Publication: 2026 Jun 25. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Adis, Springer International Country of Publication: New Zealand NLM ID: 8412297 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1179-2035 (Electronic) Linking ISSN: 01121642 NLM ISO Abbreviation: Sports Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: Auckland : Adis, Springer International Original Publication: [Auckland, N.Z. ; Newtown, PA] : ADIS |
| Ιατρικοί όροι (MeSH): | Anterior Cruciate Ligament Injuries*/surgery , Athletic Injuries*/surgery , Clinical Decision-Making* , Anterior Cruciate Ligament Reconstruction*, Humans ; Male ; Delphi Technique ; United Kingdom ; Canada ; Australia ; Consensus ; Adult ; Decision Making, Shared ; Orthopedic Surgeons ; Decision Making |
| Περίληψη: | Background: Prolonged surgical waiting lists and changing healthcare systems have raised questions about the best approach to anterior cruciate ligament (ACL) injury management in athletes, highlighting the need for consultant knee surgeon consensus. Objective: The aim was to establish consultant knee surgeon consensus on ACL injury management for athletes. Methods: Twenty-two male consultant knee surgeons from the United Kingdom (UK) (n = 18), Australia (n = 2), and Canada (n = 2) completed all three rounds of a Delphi survey between April and September 2024, responding to statements developed from the existing literature and clinical expertise. Results: Median responses ranged from strong agreement to strong disagreement, indicating diverse views, with narrower interquartile ranges in later rounds suggesting increasing consensus. Agreement was observed for rehabilitation‑focused approaches, patient involvement in shared decision making, and clinical factors such as knee stability and concomitant injury, while patient age and level of sport were less consistently prioritised. Disagreement persisted regarding surgical risk, including whether surgery would be required, and graft preferences (autologous versus synthetic). Some items reached full agreement (100%) or showed clustered responses (interquartile range = 0). Most items were stable between rounds (Wilcoxon: p = 0.16-1.00), although variability was observed for first-choice management, inclusion of lateral extra-articular procedures, and preferred lateral extra-articular procedure type, despite minimal median change (Wilcoxon: p = 0.02-0.09). Kendall's W indicated strong agreement in round 2 (W = 0.532, p < 0.001) and round 3 (W = 0.672, p < 0.001). Conclusions: These findings may support clinicians and athletes in navigating complex treatment decisions, particularly where public healthcare delays challenge conventional surgical pathways. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Confirmation of Ethical Compliance: Ethics approval was granted by the Faculty of Health and Education Research Ethics and Governance Committee at Manchester Metropolitan University (No. 63076, 02/09/2024). Consent to Participate: All participants were provided with a Participant Information Sheet that fully explained what the study involved, how their data would be handled, the benefits and risks involved, and that participation was voluntary with the right to withdraw at any time. All participants provided written informed consent. Data Availability: Data supporting the findings of this study are available in Supplement 6 in the electronic supplementary material. Declaration of Interest Statement: The authors acknowledge that personal networks were used to recruit participants. No other conflicts of interest are declared. Patient and Public Involvement: Patients and the public were not involved in the design, conduct, reporting, or dissemination of this study, beyond piloting the questionnaire with an individual who met the study’s inclusion criteria. Consent Publication: Not applicable. Author contribution: The initial idea was conceived by CT and developed with input from GY and ND. CT, GY, and ND were responsible for the conceptualisation and methodological design. Participants were recruited by GY, CT, and NJ. Formal analysis was conducted by ND. Data interpretation was undertaken by GY, CT, and ND. GY prepared the original draft of the manuscript. All authors contributed to the review and editing of the manuscript. All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship, have approved the final version of the manuscript, and agree to be accountable for the work. Code Availability: The R code used to for data visualisation is presented in Supplement 5. |
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| Entry Date(s): | Date Created: 20260625 Date Completed: 20260925 Latest Revision: 20260928 |
| Update Code: | 20260928 |
| PubMed Central ID: | PMC13615100 |
| DOI: | 10.1007/s40279-026-02480-x |
| PMID: | 42348057 |
| Βάση Δεδομένων: | MEDLINE |
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