Bilateral Simultaneous Anterior Cruciate Ligament Injury: A Case Report and National Survey of Orthopedic Surgeon Management Preference

Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medi-cine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the liter-ature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simul-taneous bilateral ACL tear and preferred man-agement strategies by sports medicine ortho-pedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions per-formed, number of bilateral simultaneous ACL injuries seen and optimal management strate-gies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar ten-don autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study.

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