Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleResults From the Swedish National Anterior Cruciate Ligament Register
Section snippets
Methods
The main functions of the Swedish ACL Register have previously been reported.2 The register is a general database that uses a Web-based protocol. On the basis of the Swedish social security number, age and gender are registered automatically, and the most recent postal address is continuously updated. The protocol consists of 2 parts: 1 in which the surgeons report baseline and surgical data and 1 with patient-reported outcome measurements (PROMs).
In the surgeon-reported section, factors such
Results
By December 2012, 23,744 patients had been entered into the surgeon-related part of the register; 22,059 unique patients had undergone primary ACL reconstruction, and 1,685 patients had undergone either multiple-ligament reconstructions or revision surgery. Thirty-seven patients had incomplete data, 530 reconstructions were performed on the contralateral knee (i.e., patients had undergone bilateral ACL reconstructions on different occasions), and 1,431 revision reconstructions had been
Discussion
The principal findings in this study were that the revision and contralateral reconstruction rates have decreased compared with a previous report from the Swedish register.2 Patients who had undergone revision or bilateral ACL reconstruction had a poorer outcome than patients who had undergone primary ACL reconstruction. Furthermore, smokers fared less well than nonsmokers. Gender- and graft-related differences were small, and a shift from the use of transfixation devices to cortical fixation
Conclusions
Soccer is the most common cause of injury in both female and male patients, and patients undergoing revisions fare less well than those undergoing primary unilateral ACL reconstructions, as well as bilateral reconstructions. Furthermore, smokers fare less well than nonsmokers. The cumulative risk of an ACL revision or contralateral ACL reconstruction during a 5-year period is approximately 7%. For patients aged younger than 19 years, the cumulative risk is significantly higher.
Acknowledgment
The authors gratefully acknowledge statistician Henrik Magnusson for performing the statistical analysis on the database.
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The authors report the following potential conflict of interest or source of funding: J. Kartus receives support from Linvatec Sweden for lectures.