Application and Surgical Technique of ACL Reconstruction Using Worldwide Registry Datasets: What Can We Extract?

Ulrike Wittig,Patrick Reinbacher,Ines Vielgut,Patrick Sadoghi,Andreas Leithner,Georg Hauer

doi:10.3390/jfmk7010002

Ulrike Wittig, Patrick Reinbacher + Show 4 more

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https://doi.org/10.3390/jfmk7010002

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Abstract

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. The purpose of this study was to compare surgical reconstruction of the ACL between different countries and regions in order to describe differences regarding epidemiological data, reconstruction frequency, and graft choice. A systematic literature search was performed using the ACL study group website in order to identify the relevant knee ligament registers. Four national registries were included, comprising those from Sweden, the UK, New Zealand, and Norway. A large variation was found concerning the total number of primary ACL reconstructions with a reported range from 4.1 to 51.3 per 100,000 inhabitants. The country-specific delay between injury and reconstruction varied between an average of 6.0 months and 17.6 months. The leading sports activities resulting in ACL injury included soccer, alpine skiing, handball, rugby, and netball. Moreover, a strong variability in graft choice for primary reconstruction was found. The comparison of ACL registers revealed large differences, indicating different clinical implications regarding conservative or surgical therapy and choice of the preferable graft. ACL registers offer a real-world clinical perspective with the aim to improve quality and patient safety by investigating factors associated with subsequent surgical outcomes.

Highlights

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries, with an incidence of 68.6 per 100,000 inhabitants [1]
In athletes, ACL rupture is reported as the knee ligament injury that most often requires surgical reconstruction [2]
ACL registers that fulfilled the following inclusion criteria were considered for evaluation: (1) Reports had to be publicly available, (2) reports had to be written in English language, and (3) data had to be reported from the years 2019 or 2020 to retrieve recent data

Summary

Introduction

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries, with an incidence of 68.6 per 100,000 inhabitants [1]. In athletes, ACL rupture is reported as the knee ligament injury that most often requires surgical reconstruction [2]. Studies have shown a steady increase of ACL reconstructions in recent years [1,3]. Along with symptomatic knee instability, ACL injury involves an increased risk of meniscal and cartilage lesions and premature osteoarthritis (OA), regardless of treatment [4,5]. Studies show that more than half of all patients suffering an ACL injury will develop symptomatic osteoarthritis in the following 10 to 20 years [6,7]

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