{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:00:12Z","timestamp":1754161212455,"version":"3.41.2"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec010\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Anterior cruciate ligament reconstruction (ACLR) is one of the most common surgical procedures in sports orthopedics; however, there is a lack of literature related to this topic in Peru. This study aimed to describe the current surgical preferences in ACLR among Peruvian orthopedic surgeons.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec011\">\n<jats:title>Methods<\/jats:title>\n<jats:p>An analytical cross-sectional study based on an online survey sent to 500 Peruvian orthopedic surgeons, supplemented with physical surveys distributed during the \u201cIX OrthoTrauma Update\u201d congress held in October 2022 in Lima, Peru. The survey collected demographic characteristics (e.g., residence area, health care sector), employment characteristics (e.g., experience as orthopedic surgeon, experience in ACLR), and surgical preferences for ACLR (choice of femoral tunnel drilling technique, choice of graft, tourniquet use). A total of 162 surgeons responded (32.4%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec012\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 134 responses were analyzed. 50% (n\u2009=\u200967; 95% CI: 41.5\u201358.5) of orthopedic surgeons had more than 10 years of experience, and 53.7% (n\u2009=\u200972; 95% CI: 45.2\u201362.1) had less than 5 years of experience in ACLR. Anteromedial portal was the most popular choice for femoral tunnel drilling (62.7%; n\u2009=\u200984; 95% CI: 54.1\u201370.5). Additionally, 85.1% preferred using autograft and 83.6% (n\u2009=\u2009114; 95% CI: 77.9\u201390.2) of surgeons reported a preference to obtain the graft from hamstrings.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec013\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>To our knowledge, this is the first report to describe the surgical preferences for ACLR among Peruvian orthopedic surgeons, revealing a predominant preference for autografts and hamstring tendon grafts, as well as a high frequency of the anteromedial (AM) portal technique and variability in tourniquet use.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0327966","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T17:22:28Z","timestamp":1753723348000},"page":"e0327966","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical preferences in anterior cruciate ligament reconstruction: A cross-sectional study in a low-middle income country"],"prefix":"10.1371","volume":"20","author":[{"given":"Jos\u00e9 Fernando","family":"S\u00e1nchez-Carbonel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Calmet-Rojas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-2112","authenticated-orcid":true,"given":"Fabriccio J.","family":"Visconti-Lopez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8339-162X","authenticated-orcid":true,"given":"Diego","family":"Urrunaga-Pastor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Torres-Manrique","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"issue":"2","key":"pone.0327966.ref001","doi-asserted-by":"crossref","first-page":"82","DOI":"10.5312\/wjo.v7.i2.82","article-title":"Biomechanics of the anterior cruciate ligament: physiology, rupture and reconstruction techniques","volume":"7","author":"C Domnick","year":"2016","journal-title":"World J Orthop"},{"issue":"1","key":"pone.0327966.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.csm.2016.08.001","article-title":"Epidemiology and diagnosis of anterior cruciate ligament injuries","volume":"36","author":"CC Kaeding","year":"2017","journal-title":"Clin Sports Med"},{"issue":"5","key":"pone.0327966.ref003","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1055\/s-0035-1544193","article-title":"Trends and demographics in anterior cruciate ligament reconstruction in the United States","volume":"28","author":"MP Leathers","year":"2015","journal-title":"J Knee Surg"},{"key":"pone.0327966.ref004","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1177\/0363546514542796","article-title":"Incidence and trends of anterior cruciate ligament reconstruction in the United States","volume":"42","author":"NA Mall","year":"2014","journal-title":"Am J Sports Med"},{"issue":"2","key":"pone.0327966.ref005","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1302\/2046-3758.32.2000241","article-title":"Basic science of anterior cruciate ligament injury and repair","volume":"3","author":"AM Kiapour","year":"2014","journal-title":"Bone Joint Res"},{"issue":"1","key":"pone.0327966.ref006","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/1941738110386185","article-title":"Allograft versus autograft anterior cruciate ligament reconstruction: predictors of failure from a MOON prospective longitudinal cohort","volume":"3","author":"CC Kaeding","year":"2011","journal-title":"Sports Health"},{"issue":"3","key":"pone.0327966.ref007","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1177\/0363546514561745","article-title":"Risk factors associated with revision and contralateral anterior cruciate ligament reconstructions in the Kaiser Permanente ACLR registry","volume":"43","author":"GB Maletis","year":"2015","journal-title":"Am J Sports Med"},{"issue":"4","key":"pone.0327966.ref008","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1177\/0363546519849483","article-title":"Hamstring autograft versus hybrid graft for anterior cruciate ligament reconstruction: a systematic review","volume":"48","author":"H-D Wang","year":"2020","journal-title":"Am J Sports Med"},{"issue":"7","key":"pone.0327966.ref009","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/j.arthro.2011.12.015","article-title":"Comparison of 4 femoral tunnel drilling techniques in anterior cruciate ligament reconstruction","volume":"28","author":"AI Larson","year":"2012","journal-title":"Arthroscopy"},{"issue":"4","key":"pone.0327966.ref010","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/JSM.0b013e3182580cd0","article-title":"Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management","volume":"22","author":"L Siegel","year":"2012","journal-title":"Clin J Sport Med"},{"issue":"14","key":"pone.0327966.ref011","doi-asserted-by":"crossref","first-page":"3378","DOI":"10.1177\/0363546518805086","article-title":"Femoral tunnel drilling method: risk of reoperation and revision after anterior cruciate ligament reconstruction","volume":"46","author":"SG Tejwani","year":"2018","journal-title":"Am J Sports Med"},{"issue":"1","key":"pone.0327966.ref012","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1186\/s12891-020-03351-w","article-title":"Comparison of clinical results of anteromedial and transtibial femoral tunnel drilling in ACL reconstruction","volume":"21","author":"L Metso","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"issue":"8","key":"pone.0327966.ref013","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s00167-009-0964-0","article-title":"The transtibial versus the anteromedial portal technique in the arthroscopic bone-patellar tendon-bone anterior cruciate ligament reconstruction","volume":"18","author":"E Alentorn-Geli","year":"2010","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"1","key":"pone.0327966.ref014","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1055\/s-0030-1247719","article-title":"Current trends in anterior cruciate ligament reconstruction","volume":"22","author":"TR Duquin","year":"2009","journal-title":"J Knee Surg"},{"issue":"3","key":"pone.0327966.ref015","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.arthro.2010.07.018","article-title":"Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique","volume":"27","author":"A Bedi","year":"2011","journal-title":"Arthroscopy"},{"key":"pone.0327966.ref016","first-page":"1","article-title":"Clinical outcome of anterior cruciate ligament reconstruction with modified transtibial and anteromedial portal","author":"S Vijayan","year":"2021","journal-title":"Musculoskelet Surg"},{"issue":"1","key":"pone.0327966.ref017","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.csm.2016.08.004","article-title":"Indications for two-incision (outside-in) anterior cruciate ligament reconstruction","volume":"36","author":"BR Branam","year":"2017","journal-title":"Clin Sports Med"},{"issue":"4","key":"pone.0327966.ref018","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1007\/s00167-015-3950-8","article-title":"Comparison of tunnel variability between trans-portal and outside-in techniques in ACL reconstruction","volume":"25","author":"J-A Sim","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"2","key":"pone.0327966.ref019","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jor.2017.03.002","article-title":"All-inside ACL reconstruction: How does it compare to standard ACL reconstruction techniques?","volume":"14","author":"AJ Connaughton","year":"2017","journal-title":"J Orthop"},{"key":"pone.0327966.ref020","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1177\/1941738118803616","article-title":"Trends in incidence of ACL reconstruction and concomitant procedures among commercially insured individuals in the United States, 2002-2014","volume":"10","author":"MM Herzog","year":"2018","journal-title":"Sports Health"},{"key":"pone.0327966.ref021","first-page":"1","article-title":"New trends in ACL research","author":"V Musahl","year":"2011","journal-title":"KSSTA"},{"issue":"2","key":"pone.0327966.ref022","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s00264-012-1611-9","article-title":"An international survey on anterior cruciate ligament reconstruction practices","volume":"37","author":"O Chechik","year":"2013","journal-title":"Int Orthop"},{"issue":"3","key":"pone.0327966.ref023","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1055\/s-0038-1672157","article-title":"New trends in anterior cruciate ligament reconstruction: a systematic review of national surveys of the last 5 years","volume":"6","author":"A Grassi","year":"2018","journal-title":"Joints"},{"issue":"3","key":"pone.0327966.ref024","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1111\/jan.14669","article-title":"The factors related to a sedentary lifestyle: a meta-analysis review","volume":"77","author":"LCG Martins","year":"2021","journal-title":"J Adv Nurs"},{"issue":"4","key":"pone.0327966.ref025","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2021-001172","article-title":"Injury epidemiology in professional football in South America compared with Europe","volume":"7","author":"H Bengtsson","year":"2021","journal-title":"BMJ Open Sport Exerc Med"},{"issue":"4","key":"pone.0327966.ref026","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.ST.18.00017","article-title":"Knee arthroscopy: a simulation demonstrating the Imperial Knee Arthroscopy Cognitive Task Analysis (IKACTA) Tool","volume":"8","author":"R Bhattacharyya","year":"2018","journal-title":"JBJS Essent Surg Tech"},{"key":"pone.0327966.ref027","article-title":"A slight degree of osteoarthritis appears to be present after anterior cruciate ligament reconstruction compared with contralateral healthy knees at a minimum of 20 years: A systematic review of the literature","volume":"11","author":"R D\u2019Ambrosi","year":"2024","journal-title":"J Exp Orthop"},{"issue":"2","key":"pone.0327966.ref028","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/00913847.2016.1154448","article-title":"The learning curve associated with anteromedial portal drilling in ACL reconstruction","volume":"44","author":"TA Luthringer","year":"2016","journal-title":"Phys Sportsmed"},{"issue":"6","key":"pone.0327966.ref029","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1177\/0363546510397170","article-title":"Anterior cruciate ligament reconstruction: can anatomic femoral placement be achieved with a transtibial technique?","volume":"39","author":"DP Piasecki","year":"2011","journal-title":"Am J Sports Med"},{"issue":"5","key":"pone.0327966.ref030","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1007\/s00264-010-1000-1","article-title":"Anteromedial portal versus transtibial drilling techniques in ACL reconstruction: a blinded cross-sectional study at two- to five-year follow-up","volume":"34","author":"E Alentorn-Geli","year":"2010","journal-title":"Int Orthop"},{"issue":"2","key":"pone.0327966.ref031","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/JSA.0000000000000265","article-title":"Graft selection in anterior cruciate ligament reconstruction","volume":"28","author":"KM Lin","year":"2020","journal-title":"Sports Med Arthrosc Rev"},{"issue":"4","key":"pone.0327966.ref032","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.csm.2007.06.006","article-title":"Bone-patella tendon-bone autograft anterior cruciate ligament reconstruction","volume":"26","author":"RJ Schoderbek","year":"2007","journal-title":"Clin Sports Med"},{"key":"pone.0327966.ref033","article-title":"Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults","author":"NGH Mohtadi","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"issue":"9","key":"pone.0327966.ref034","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1055\/s-0039-1688555","article-title":"Is it better to routinely use tourniquet for knee arthroscopic surgery: a systematic review and meta-analysis","volume":"33","author":"J Wang","year":"2020","journal-title":"J Knee Surg"},{"issue":"4","key":"pone.0327966.ref035","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1007\/s00776-013-0405-2","article-title":"The effect of tourniquet use on operative performance and early postoperative results of anatomic double-bundle anterior cruciate ligament reconstruction","volume":"18","author":"H Nakayama","year":"2013","journal-title":"J Orthop Sci"},{"key":"pone.0327966.ref036","first-page":"2948","article-title":"Anterior cruciate ligament reconstruction; is a tourniquet necessary? A randomized controlled trial","volume":"24","author":"W Reda","year":"2016","journal-title":"KSSTA"},{"issue":"14","key":"pone.0327966.ref037","doi-asserted-by":"crossref","first-page":"4030","DOI":"10.1177\/0363546521988943","article-title":"Tranexamic acid in anterior cruciate ligament reconstruction: a systematic review and meta-analysis","volume":"49","author":"WL Johns","year":"2021","journal-title":"Am J Sports Med"},{"issue":"2","key":"pone.0327966.ref038","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/0363546516666818","article-title":"A multicenter study of early anti-inflammatory treatment in patients with acute anterior cruciate ligament tear","volume":"45","author":"C Lattermann","year":"2017","journal-title":"Am J Sports Med"},{"issue":"161","key":"pone.0327966.ref039","article-title":"The impact of aspiration and corticosteroid injection after ACL injury on post-reconstruction infection rate","volume":"9","author":"W Cantrell","year":"2021","journal-title":"Orthop J Sports Med"},{"issue":"6","key":"pone.0327966.ref040","first-page":"773","article-title":"Corticosteroid treatment induces chondrocyte apoptosis in an experimental arthritis model and in chondrocyte cultures","volume":"20","author":"F Nakazawa","year":"2002","journal-title":"Clin Exp Rheumatol"},{"key":"pone.0327966.ref041","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.arthro.2014.11.022","article-title":"Platelet-rich plasma use in anterior cruciate ligament surgery: systematic review of the literature","volume":"31","author":"D Figueroa","year":"2015","journal-title":"Arthroscopy"},{"issue":"2","key":"pone.0327966.ref042","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1177\/230949901202000205","article-title":"Hyaluronic acid instillation following arthroscopic anterior cruciate ligament reconstruction: a double-blinded, randomised controlled study","volume":"20","author":"JYM Chau","year":"2012","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"4","key":"pone.0327966.ref043","doi-asserted-by":"crossref","DOI":"10.1016\/j.arthro.2021.01.023","article-title":"Pain management strategies after anterior cruciate ligament reconstruction: a systematic review with network meta-analysis","volume":"37","author":"MS Davey","year":"2021","journal-title":"Arthroscopy"},{"issue":"1","key":"pone.0327966.ref044","doi-asserted-by":"crossref","DOI":"10.1016\/j.asmr.2021.11.002","article-title":"Contemporary principles for postoperative rehabilitation and return to sport for athletes undergoing anterior cruciate ligament reconstruction","volume":"4","author":"CR Badawy","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"6","key":"pone.0327966.ref045","first-page":"372","article-title":"Physiotherapy after reconstruction of anterior cruciate ligament","volume":"20","author":"M Pereira","year":"2012","journal-title":"Acta Ortop Bras"},{"issue":"5","key":"pone.0327966.ref046","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1016\/j.arthro.2021.01.042","article-title":"Anterior cruciate ligament reconstruction graft preference most dependent on patient age: a survey of United States surgeons","volume":"37","author":"EN Bowman","year":"2021","journal-title":"Arthroscopy"},{"issue":"1","key":"pone.0327966.ref047","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jisako.2022.08.009","article-title":"Current trends in anterior cruciate ligament surgery. A worldwide benchmark study","volume":"8","author":"M Tuca","year":"2023","journal-title":"J ISAKOS"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327966","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T17:22:36Z","timestamp":1753723356000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0327966"}},"subtitle":[],"editor":[{"given":"Esmaiel","family":"Jabbari,","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":47,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0327966","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2025,7,28]]}}}