Evidence map›Paper›PMID 40080635›Full record

ArticlePhysical therapy2025

Treatment Decision-Making for Anterior Cruciate Ligament Rupture From the Perspective of Physical Therapists in Australia: A Mixed Methods Study.

Stephanie R Filbay, Jane Rooney, Tammy Hoffmann, Zobaida Edib, Pek Ling Teo, Rana S Hinman, Kim L Bennell

Abstract read
In one paragraph

Article in Physical therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stephanie R FilbayCentre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria 3010, Australia.ORCID 0000-0002-9624-0791
Jane RooneyLifecare Prahran Sports Medicine Centre, South Yarra, Victoria 3141, Australia.
Tammy HoffmannInstitute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia.ORCID 0000-0001-5210-8548
Zobaida EdibCentre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria 3010, Australia.ORCID 0000-0001-7381-7351
Pek Ling TeoCentre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria 3010, Australia.ORCID 0000-0003-1657-1820
Rana S HinmanCentre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria 3010, Australia.ORCID 0000-0001-6368-9456
Kim L BennellCentre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria 3010, Australia.ORCID 0000-0003-4982-5639

Funding

Australian and New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network SeedingNational Health and Medical Research Council (NHMRC) Investigator 1194428NHMRC Investigator 1174431NHMRC Investigator 2025733
6 · The paper itself

Abstract

importanceIn Australia, few people with acute anterior cruciate ligament (ACL) rupture are managed with rehabilitation alone despite clinical trials demonstrating similar outcomes to ACL reconstruction (ACLR). The reasons for the low uptake of rehabilitation alone for the treatment of acute ACL rupture in Australia are unclear.

objectivesThe objectives of this study were to evaluate physical therapists' beliefs and the information they provide to patients about treatment options for ACL rupture, and to explore ACL rupture treatment decision-making from the perspective of physical therapists.

designThe design was a mixed-methods convergent parallel design comprising an Australia-wide survey (n = 246) and semi-structured interviews (n = 10).

participantsParticipants included physical therapists who manage people with ACL rupture in Australia. MAIN OUTCOMES: The survey contained 41 items that assessed demographics, treatment of ACL rupture, referral pathways, treatment beliefs, and the information provided to patients with ACL rupture.

resultsPhysical therapists' beliefs about treatment options varied and did not always reflect the information they provided to patients. Although 60% agreed that ACLR and rehabilitation-alone result in similar outcomes on average, only 37% reported regularly informing patients about this. To return to pivoting/contact sport, 23% believed that ACLR was required and 79% informed patients that ACLR was the best treatment to do so. Physical therapists felt that rehabilitation-alone is underutilized as a treatment for ACL rupture. Physical therapists encountered barriers to offering and providing rehabilitation-alone for ACL rupture, reflected in 7 qualitative themes: preference for surgery reflecting societal beliefs; more weight given to surgeon's opinion; unbalanced information from surgeon; referral pathways; uncertain recovery timeline; beliefs about treatment suitability; and knowledge and experience.

conclusionsPhysical therapists had mixed beliefs about treatment options and the information provided to patients was not always evidence based. Physical therapists felt that nonsurgical management was underutilized, and experienced barriers to offering and providing non-surgical management of ACL rupture in clinical practice. RELEVANCE: Informed decision-making can only occur if accurate, evidence-based information about ACL rupture treatment options is provided to patients. These findings may be used to guide professional development for physical therapists and inform strategies to improve evidence uptake by physical therapists.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionAttitude of Health PersonnelClinical Decision-MakingDecision MakingPhysical TherapistsAdultAustraliaFemaleHumansInterviews as TopicMaleMiddle AgedSurveys and QuestionnairesAnterior Cruciate Ligament InjuryAnterior Cruciate Ligament ReconstructionEvidence-Based PracticePhysiotherapyQualitativeShared Decision-Making

Identifiers

PMID40080635
PMCPMC12074573

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.