University of Rhode Island
Mentor: Daniel R. Sedory, M.S., ATC, Assistant Professor of Kinesiology
Patients' Preoperative Knowledge of the Anterior Cruciate Ligament Reconstructive Surgery: Physician-Patient Communication
Communication in the medical field, and on a professional level, is expected to be an informative interaction of seeking and giving between the patient and the physician. In this research project an extensive literature review examines the patient and physician roles in the process of medical information exchange without the aid of a third party or advocate. Previous research suggests that 90% of patients value having as much information as possible from their physician. However, 54% of patient complaints are directed toward the physicianss communicative approach when sharing information. Continuing Medical Educational Programs (CME) have been developed for the physicians to enhance their communication skills, and patient-centered programs focus on helping the patient and the physician establish a relationship. Although these programs are promising they do not have a profound effect on communication.
The object of this pilot study is to determine the level of knowledge a preoperative patient has about their upcoming anterior cruciate ligament (ACL) reconstructive surgery. Anonymous surveys will be distributed to at least 30 patients prior to their ACL surgery. The results of this study will help determine the dilemmas or barriers in physician-patient interaction. Barriers to good communication prevent the patients from receiving a satisfactory physician-patient experience. Examples of expected barriers to good communication are: emotional states such as anxiety, the patient's level of understanding, the patient's ability to process information, the time allotted per consultation, availability of the physician, the patient's general lack of knowledge, and the physician's communicating style and behavior.
Future studies on how to improve the communication for both the physician and patient through a third party or advocate should assist in making the physician-patient interaction more rewarding.
Mentor: Daniel R. Sedory M.S., A.T.C., Assistant Professor, Kinesiology
A Comparison of the Factors Involved in the Autograft vs. Allograft Anterior Cruciate Ligament Reconstructive Surgery
The anterior cruciate ligament (ACL) is one of the two cruciate ligaments in the knee which functions to prevent anterior displacement of the tibia on the femur, limits full hyperextension, and resists posterior translation of the femur in relation to the tibia. In this research an extensive literature review was conducted to discover if there were any significant differences between the autograft and allograft ACL reconstructive surgery.
In analyzing both procedures, the advantages and disadvantages of both surgeries were addressed and the factors involved in each procedure were compared. The positive attributes discovered for the autograft were high tensile strength, ability to revascularize, and bony plug insertions. For the allograft, the positive attributes were the mechanical advantages over the patellar tendon autograft, a more abundant supply of tissue, less operative time, superior cosmetic results, and the ability to avoid the morbidity associated with autograft harvesting.
Complications among both procedures were also discovered. The negative attributes for the autograft were increased chances of patellar fracture, patellar tendinitis, patellar tendon rupture, quadriceps tendon rupture, patellofemoral dysfunction, flexion contracture, and diminished structural properties of the remaining patellar tendon. The negative attributes discovered for the allograft procedure were: the possibility of disease transmission and stimulation of an immune response.
The results of this study indicate there is no significant difference in functional capacity when comparing the allograft to the autograft surgery. In fact, the autograft and the allograft procedures have similar outcomes and through this study prove to be equivalent. This study brings forth the notion that further research is necessary to clarify perceptions about each procedures and how it may effect the outcome of the ACL reconstructive surgery.