2025年ACL重建管理技术趋势：美国职业足球大联盟队医调查
简介
2025年美国职业足球大联盟（MLS）队医调查显示，在职业足球运动员初次前交叉韧带重建（ACLR）中，74%的医生首选骨-髌腱-骨（BPTB）自体移植物，股四头肌腱（QT）自体移植物占22.2%，腘绳肌腱（HT）仅占3.7%；翻修手术则以QT自体移植物最常用（48.2%）。此外，外侧关节外加强（LEA）在初次和翻修ACLR中的应用率分别达31.5%和76%，…
英文摘要
BACKGROUND: The optimal graft choice for anterior cruciate ligament reconstruction (ACLR) remains a subject of ongoing debate. In practice, graft selection in ACLR is multifactorial, with patient characteristics, activity level, and surgeon preference/training background all playing a crucial role in the clinical decision-making process. While graft trends have been reported across select professional sports leagues, none have focused specifically on professional soccer. PURPOSE: To report current trends in graft preference for ACLR among Major League Soccer (MLS) surgeons. STUDY DESIGN: Cross-sectional study. METHODS: A 39-question survey was distributed to 27 orthopaedic surgeons affiliated with MLS teams in January 2025. The questionnaire captured each respondent's preferences regarding ACLR management in both the general population and high-level/professional soccer athletes. Descriptive statistics were used to summarize responses. RESULTS: Surgeons averaged 7.7 years caring for MLS teams and performed a mean of 80 ± 27 ACLRs annually. In primary ACLR for professional soccer athletes, the bone-patellar tendon-bone (BPTB) autograft was preferred (74%), followed by the quadriceps tendon (QT) autograft (22.2%). The hamstring tendon (HT) autograft was uncommon (3.7%). Similar trends were reported for the general population: BPTB autograft (70%), QT autograft (22.2%), and HT autograft (3.7%). For revision procedures, QT autograft was favored (48.2%), followed by BPTB autograft (25.9%) and BPTB allograft (11.1%). Contralateral autografts were more common in revisions (44.4%) than in primary cases (7.4%). Lateral extra-articular augmentation (LEA) was performed in 31.5% of primary cases and 76% of revision cases; iliotibial band tenodesis was favored over anterolateral ligament reconstruction (74.1% vs 25.9%). LEA utilization increased compared with 5 years prior (6.4% vs 29.4%). CONCLUSION: Among orthopaedic surgeons caring for MLS athletes, BPTB autografts were the preferred graft for primary ACLR. QT autografts were preferred over HT autografts in primary ACLR, and QT autografts were most commonly used in revision surgery. HT autografts were rarely used in primary ACLR and were not preferred in revision scenarios. LEA procedures were widely used among professional soccer athletes.