Treatment decision-making process after an anterior cruciate ligament injury: patients', orthopaedic surgeons' and physiotherapists' perspectives

Objective To investigate the treatment decision-making process after an anterior cruciate ligament (ACL) injury from patients', orthopaedic surgeons' and physiotherapists' perspectives. Methods The study is a part of the NACOX study, which is designed to describe the natural corollaries after ACL injury. For the present study, a subgroup 101 patients were included. Patients, their orthopaedic surgeons and their physiotherapists, answered a Shared Decision-Making Process (SDMP) questionnaire, when treatment decision for ACL reconstruction surgery (ACLR) or non-reconstruction (non-ACLR) was taken. The SDMP questionnaire covers four topics: informed patient, to be heard, involvement and agreement. Results Most (75-98%) patients considered their needs met in terms of being heard and agreement with the treatment decision. However, fewer in the non-ACLR group compared to the ACLR group reported satisfaction with information from the orthopaedic surgeon (67% and 79%), or for their own involvement in the treatment decision process (67% and 97%). Conclusion and practice implications Most patients and caregivers considered that patients' needs to be informed, heard and involved, and to agree with the decision about the treatment process, were fulfilled to a high extent. However, patients where a non-ACLR decision was taken experienced being involved in the treatment decision to a lower extent. This implies that the non-ACLR treatment decision process needs further clarification, especially from the patient involvement perspective.

Automated summary

This study investigated the treatment decision-making process for patients with anterior cruciate ligament (ACL) injury from the perspectives of patients, orthopaedic surgeons, and physiotherapists. The results showed that most patients felt their needs were met in terms of being heard and agreement with the treatment decision. However, patients in the non-ACLR group reported lower satisfaction with information from the orthopaedic surgeon and their own involvement in the treatment decision process.