Afshin Arianjam1, Maria C S Inacio2, Tadashi T Funahashi3, Gregory B Maletis4. 1. St. Joseph Health, Kaiser Permanente Orange County, California, USA. 2. Surgical Outcomes and Analysis Department, Kaiser Permanente, San Diego, California, USA. 3. Kaiser Permanente, Irvine, California, USA. 4. Kaiser Permanente, Baldwin Park, California, USA.
Abstract
BACKGROUND: Knowledge of patient characteristics, surgical fixation, graft choice, outcomes, and concurrent injuries of revision anterior cruciate ligament reconstruction (ACLR) is limited. PURPOSE: To describe the current cohort of revision ACLR captured by a community registry and the outcomes observed in the registered patients. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Patients who underwent revision ACLR registered between February 2005 and June 2014, by 200 surgeons in 46 hospitals, were evaluated. The Kaiser Permanente ACLR Registry (KPACLRR) collected data intraoperatively and postoperatively using paper forms, electronic medical records, administrative claims data, and patient-reported outcomes. The KPACLRR cohort was longitudinally followed, and outcomes were prospectively ascertained. Outcomes (ie, revisions, subsequent operative procedures, deep surgical site infections, and deep venous thrombosis) were adjudicated via a chart review. Descriptive statistics were employed. RESULTS: Of 2019 patients who underwent revision ACLR, at a median follow-up of 2.2 years (interquartile range, 1.0-3.8 years), 212 (10.5%) required subsequent operative procedures, and 86 (4.3%) were revised a second time. At the time of revision, 55.1% of the patients had at least 1 concurrent meniscal injury, and 26% of those were repairable. Cartilage injuries were present in 42.0% of patients. Deep surgical site infections occurred in 12 patients (0.6%), deep venous thrombosis occurred in 5 patients (0.3%), and 1 patient (0.1%) had a pulmonary embolism. CONCLUSION: Revision ACLR can be performed with a low short-term revision rate and relatively few complications. At the time of revision, nearly half of these patients had an irreparable meniscal injury, and slightly less than half had a cartilage injury. A large community-based ACLR registry is useful in informing surgeons of current treatment practices, prevalence of concurrent injuries, and outcomes associated with the procedures, especially infrequent procedures such as revision ACLR.
BACKGROUND: Knowledge of patient characteristics, surgical fixation, graft choice, outcomes, and concurrent injuries of revision anterior cruciate ligament reconstruction (ACLR) is limited. PURPOSE: To describe the current cohort of revision ACLR captured by a community registry and the outcomes observed in the registered patients. STUDY DESIGN: Case series; Level of evidence, 4. METHODS:Patients who underwent revision ACLR registered between February 2005 and June 2014, by 200 surgeons in 46 hospitals, were evaluated. The Kaiser Permanente ACLR Registry (KPACLRR) collected data intraoperatively and postoperatively using paper forms, electronic medical records, administrative claims data, and patient-reported outcomes. The KPACLRR cohort was longitudinally followed, and outcomes were prospectively ascertained. Outcomes (ie, revisions, subsequent operative procedures, deep surgical site infections, and deep venous thrombosis) were adjudicated via a chart review. Descriptive statistics were employed. RESULTS: Of 2019 patients who underwent revision ACLR, at a median follow-up of 2.2 years (interquartile range, 1.0-3.8 years), 212 (10.5%) required subsequent operative procedures, and 86 (4.3%) were revised a second time. At the time of revision, 55.1% of the patients had at least 1 concurrent meniscal injury, and 26% of those were repairable. Cartilage injuries were present in 42.0% of patients. Deep surgical site infections occurred in 12 patients (0.6%), deep venous thrombosis occurred in 5 patients (0.3%), and 1 patient (0.1%) had a pulmonary embolism. CONCLUSION: Revision ACLR can be performed with a low short-term revision rate and relatively few complications. At the time of revision, nearly half of these patients had an irreparable meniscal injury, and slightly less than half had a cartilage injury. A large community-based ACLR registry is useful in informing surgeons of current treatment practices, prevalence of concurrent injuries, and outcomes associated with the procedures, especially infrequent procedures such as revision ACLR.
Authors: Sufian S Ahmad; Gregory S Difelice; Jelle P van der List; Atesch Ateschrang; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-12-07 Impact factor: 4.342
Authors: Janina Kaarre; Bálint Zsidai; Eric Narup; Alexandra Horvath; Eleonor Svantesson; Eric Hamrin Senorski; Alberto Grassi; Volker Musahl; Kristian Samuelsson Journal: Curr Rev Musculoskelet Med Date: 2022-07-13
Authors: Jelle P van der List; Harmen D Vermeijden; Inger N Sierevelt; Maarten V Rademakers; Mark L M Falke; Gijs T T Helmerhorst; Roy A G Hoogeslag; Wybren A van der Wal; Arthur van Noort; Gino M M J Kerkhoffs Journal: BMC Musculoskelet Disord Date: 2021-04-30 Impact factor: 2.362