Christina Lekkas1, Richard Clarnette2, Stephen E Graves1, Sophia Rainbird3, David Parker4, Michelle Lorimer5, Roger Paterson6, Justin Roe7, Hayden Morris8, Julian A Feller9, Peter Annear10, Ben Forster11, David Hayes12. 1. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, SA, 5001, Australia. 2. Wakefield Orthopaedic Clinic, Adelaide, SA, 5000, Australia. 3. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, SA, 5001, Australia. srainbird@aoanjrr.org.au. 4. Northshore Private Hospital, St Leonards, NSW, 2065, Australia. 5. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, 5001, Australia. 6. Sportsmed SA, Stepney, SA, 5069, Australia. 7. Mater Hospital, Wollstonecraft, NSW, 2065, Australia. 8. St Vincent's Private East Melbourne (Mercy), Fitzroy, VIC, 3065, Australia. 9. Epworth HealthCare, Richmond, VIC, 3121, Australia. 10. Bethesda Hospital, Claremont, WA, 6010, Australia. 11. The Wesley Hospital, Auchenflower, QLD, 4066, Australia. 12. Brisbane Private Hospital, Brisbane, QLD, 4000, Australia.
Abstract
PURPOSE: Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible. METHODS: Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data. RESULTS: A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study. CONCLUSION: It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent would not be an issue in for a national registry where inclusion is automatic unless the patient wishes to opt out. The collection of post-operative patient-reported outcome measures (PROMs) is more problematic, due to an insufficient proportion of individuals providing patient-reported outcomes. Alternative outcome measures are required for an ACL registry in Australia to be successfully implemented. LEVEL OF EVIDENCE: Diagnostic, Level III.
PURPOSE: Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible. METHODS: Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data. RESULTS: A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study. CONCLUSION: It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent would not be an issue in for a national registry where inclusion is automatic unless the patient wishes to opt out. The collection of post-operative patient-reported outcome measures (PROMs) is more problematic, due to an insufficient proportion of individuals providing patient-reported outcomes. Alternative outcome measures are required for an ACL registry in Australia to be successfully implemented. LEVEL OF EVIDENCE: Diagnostic, Level III.
Authors: Andreas Persson; Knut Fjeldsgaard; Jan-Erik Gjertsen; Asle B Kjellsen; Lars Engebretsen; Randi M Hole; Jonas M Fevang Journal: Am J Sports Med Date: 2013-12-09 Impact factor: 6.202
Authors: Mattias Ahldén; Kristian Samuelsson; Ninni Sernert; Magnus Forssblad; Jón Karlsson; Jüri Kartus Journal: Am J Sports Med Date: 2012-09-07 Impact factor: 6.202