Validating the capture rate of revisions by the New Zealand ACL Registry: An analysis of all-cause reoperation following primary ACL reconstruction.

Purpose: To validate the New Zealand Anterior Cruciate Ligament (ACL) Registry's capture rate of revisions by cross-referencing Registry data with reoperations data recorded by the Accident Compensation Corporation (ACC) and identify risk factors for all-cause reoperation.

Methods: Primary ACL reconstructions performed between April 2014 and September 2019 were individually matched on a record-by-record basis between the two databases. The ACC database was used to identify patients who underwent a reoperation with manual review of operation notes to identify whether a revision or other procedure was performed.

Risk factors for reoperation for arthrofibrosis following primary anterior cruciate ligament reconstruction.

Purpose: The purpose of this study is to identify the rate and risk factors for a reoperation for arthrofibrosis following primary anterior cruciate ligament (ACL) reconstruction.

Methods: Prospective data recorded in the New Zealand ACL Registry were cross-referenced with data from the Accident Compensation Corporation (ACC). Primary ACL reconstructions performed between April 2014 and May 2021 were analysed.

Comparison of Knee Pain and Difficulty With Kneeling Between Patellar Tendon and Hamstring Tendon Autografts After Anterior Cruciate Ligament Reconstruction: A Study From the New Zealand ACL Registry.

Background: The bone-patellar tendon-bone (BTB) autograft is associated with difficulty with kneeling after anterior cruciate ligament (ACL) reconstruction; however, it is unclear whether it results in a more painful or symptomatic knee compared with the hamstring tendon autograft.

Purpose: To identify the rate and risk factors for knee pain and difficulty with kneeling after ACL reconstruction.

Study Design: Cohort study; Level of evidence, 3.

Meniscal repair failure following concurrent primary anterior cruciate ligament reconstruction: results from the New Zealand ACL Registry.

Purpose: This study aimed to identify the risk factors for meniscal repair failure following concurrent primary anterior cruciate ligament (ACL) reconstruction.

Methods: Prospective data recorded by the New Zealand ACL Registry and the Accident Compensation Corporation were reviewed. Meniscal repairs performed during concurrent primary ACL reconstruction were included.

Digital TKA Alignment Training with a New Digital Simulation Tool (Knee-CAT) Improves Process Quality, Efficiency, and Confidence.

Individual alignment techniques have been introduced to restore patients' unique anatomical variations during total knee arthroplasty. The transition from conventional mechanical alignment to individualised approaches, with the assistance of computer and/or robotic technologies, is challenging. The objective of this study was to develop a digital training platform with real patient data to educate and simulate various modern alignment philosophies.

Prophylaxis for preventing venous thromboembolism in knee arthroscopy and soft tissue reconstruction: consensus statements from an international panel of experts.

Purpose: There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic.

Patient-Specific TKA with the VELYS™ Robotic-Assisted Solution.

The VELYS™ Robotic-Assisted Solution (VRAS) (DePuy Synthes, Warsaw, Indiana) utilises new technology to accurately collect the bony anatomy and soft tissue envelope of the knee. This enables surgeons to use this information to intraoperatively plan anatomical placement of a total knee arthroplasty (TKA) with preservation of the soft tissues with the aim of restoring functional knee motion. The robotic-assisted saw delivers precise, accurate, and efficient delivery of this implantation plan.

Suspensory Versus Interference Tibial Fixation of Hamstring Tendon Autografts in Anterior Cruciate Ligament Reconstruction: Results From the New Zealand ACL Registry.

Background: The hamstring tendon is frequently used to reconstruct the anterior cruciate ligament (ACL), but there is a lack of consensus on the optimal method of fixation. Registry studies have shown that the type of femoral fixation device can influence the risk of revision ACL reconstruction (ACLR), but it is unclear whether the type of tibial fixation has an effect. In New Zealand, over 95% of hamstring tendon grafts are fixed with an adjustable loop suspensory device on the femoral side, with variable usage between suspensory and interference devices, with or without a sheath, on the tibial side.

The crevice sign: a new indicator of meniscal instability in ACL reconstructions.

Purpose: Meniscus preservation is key in knee surgery. The newly documented crevice sign indicates instability of the medial meniscus in ACL-deficient knees. Once the sign is visualised, it is imperative that the stability of the medial meniscus is assessed and potentially treated.

Comparison of Existing and New Total Knee Arthroplasty Implant Systems From the Same Manufacturer: A Prospective, Multicenter Study.

Introduction: This study evaluated total knee arthroplasty (TKA) outcomes for an Existing-TKA versus New-TKA from the same manufacturer.

Methods: TKA outcomes for 752 with Existing-TKA versus 1129 subjects with New-TKA were followed through 2 years using patient-reported outcome measures (PROMs). Responders were assessed per Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria.

Higher Rate of Return to Preinjury Activity Levels After Anterior Cruciate Ligament Reconstruction With a Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft in High-Activity Patients: Results From the New Zealand ACL Registry.

Background: In primary anterior cruciate ligament (ACL) reconstruction, a bone-patellar tendon-bone (BTB) autograft is associated with lower ipsilateral failure rates. BTB autografts are associated with a higher rate of contralateral ACL injuries, which some clinicians view as a marker of success of the BTB autograft. However, there is a lack of evidence on whether BTB autografts improve the rate of return to activity and sport.

Editorial Commentary: Increased Tibial Slope Is Associated With Anterior Cruciate Ligament Injury Risk, and Tibial Slope Increases in the Skeletally Immature, Anterior Cruciate Ligament-Deficient Knee: A Chicken or Egg Causality Dilemma?

Increased tibial slope is associated with increased risk of anterior cruciate ligament (ACL) injury in the skeletally immature. Recent studies, however, emphasize a mutual influence, as tibial slope has been shown to increase over time in the ACL-deficient skeletally immature knee. It is hypothesized that altered biomechanics with enhanced posterior force transmission in the ACL-deficient knee may influence the developing physis, leading to altered longitudinal growth and increased tibial slope.

ACL Study Group presents the global trends in ACL reconstruction: biennial survey of the ACL Study Group.

Objectives: The primary objective of this survey was to gauge the current global trends in anterior cruciate ligament reconstruction (ACLR) as reported by the members of the Anterior Cruciate Ligament (ACL) Study Group (SG).

Methods: A survey was created and distributed among the members of the ACL SG consisting of 87 questions and 16 categories related to ACLR, including member demographics, preoperative management, primary ACLR techniques and graft choice, use of concomitant procedures and biological augmentation, postoperative rehabilitation, and more.

Results: The survey was completed by the 140 members of the ACL SG.

Editorial Commentary: The Ratio of Tibial Slope and Meniscal Bone Angle is a Strong Predictor for Anterior Cruciate Ligament Injury: A Steep Hill and a Shallow Speed Bump are a Hazardous Combination.

The lateral tibial posterior slope (LTPS) and the lateral meniscal bone angle (MBA) are important geometrical features of the knee joint and have therefore been of interest in the setting of anterior cruciate ligament injury (ACL) and ACL reconstruction. An emerging body of evidence suggests that LTPS is an independent risk factor for primary and recurrent ACL injury. Furthermore, biomechanical and clinical evidence is emphasizing the crucial contribution of the lateral meniscus to rotatory knee stability.

ACL Study Group survey reveals the evolution of anterior cruciate ligament reconstruction graft choice over the past three decades.

Purpose: Anterior cruciate ligament reconstruction (ACLR) aims to restore knee function and stability, allowing patients to return to the activities they enjoy and minimize further injury to the meniscus and cartilage and their ultimate progression to osteoarthritis. This study aims to present the evolution of graft choice over the last three decades according to members of the ACL Study Group (SG).

Methods: Prior to the January 2020 ACL SG biannual meeting, a survey was administered consisting of 87 questions and 16 categories, including ACLR graft choice.

Variable rotation of the femur does not affect outcome with patient specific alignment navigated balanced TKA.

Purpose: Excessive internal and external rotation of the femoral component has been associated with poor outcome with a measured-resection neutral mechanical alignment TKA. This technique assumes that every tibia is in 3° of varus so the femoral component is placed in 3° of external rotation relative to the posterior condylar axis to enable a balanced flexion gap. This is not the case as there is wide variability in the bony anatomy and soft tissue envelope of the knee so flexion imbalance may occur.

Effectiveness of thicker hamstring or patella tendon grafts to reduce graft failure rate in anterior cruciate ligament reconstruction in young patients.

Purpose: The purpose of this study was to determine the anterior cruciate ligament reconstruction (ACLR) failure rate in young patients utilizing the New Zealand (NZ) anterior cruciate ligament (ACL) Registry. The hypothesis was that the ACLR rupture rate would be lower for thicker hamstring graft and bone patellar tendon bone (BPB) grafts in comparison to the classic hamstring technique. The ACLR failure rate was assessed according to graft type and patients' sex.

No difference in revision rates between anteromedial portal and transtibial drilling of the femoral graft tunnel in primary anterior cruciate ligament reconstruction: early results from the New Zealand ACL Registry.

Purpose: The use of an accessory anteromedial portal to drill the femoral graft tunnel in primary anterior cruciate ligament (ACL) reconstruction was introduced in the 2000s in an effort to achieve a more anatomic femoral tunnel position. However, some early studies reported an increase in revision ACL reconstruction compared to the traditional transtibial technique. The aim of this study was to analyse recent data recorded by the New Zealand ACL Registry to compare outcomes of ACL reconstruction performed using the anteromedial portal and transtibial techniques.

Knee Arthroscopy: The "Crevice Sign," a New Pathognomonic Sign for Unstable Posterior Medial Meniscal Tear in Anterior Cruciate Ligament-Deficient Knees.

There has been increased emphasis on medial meniscus repair in the anterior cruciate ligament-reconstructed knee, as this improves stability. We describe an arthroscopic sign of an unstable medial meniscal tear that is diagnostic. The "crevice sign" is a longitudinal fissure located on the distal medial femoral condyle.

Factors associated with revision following anterior cruciate ligament reconstruction: A systematic review of registry data.

Background: To identify the patient and surgical factors associated with revision anterior cruciate ligament (ACL) reconstruction as reported by all national and community ACL registries.

Methods: A systematic review was performed on the MEDLINE, Embase and Cochrane Library databases. Eligibility criteria included English studies published by national or community ACL registries reporting on primary ACL reconstruction and risk factors associated with revision ACL reconstruction.

Risk Factors for Revision Anterior Cruciate Ligament Reconstruction and Frequency With Which Patients Change Surgeons.

Background: Revision surgery is a known complication after anterior cruciate ligament (ACL) reconstruction (ACLR), but the proportion of patients who seek a different surgeon for their revision procedure is unknown.

Purpose: To determine the rate and risk factors for revision ACLR in New Zealand and to find the proportion of patients undergoing revision ACLR who see a different surgeon compared with their primary procedure as well as the factors that may influence this decision.

Study Design: Case series; Level of evidence, 4.

Effect of Graft Choice on Revision and Contralateral Anterior Cruciate Ligament Reconstruction: Results From the New Zealand ACL Registry.

Background: The patellar tendon is often considered the "gold standard" graft for reducing the risk of graft rupture after anterior cruciate ligament (ACL) reconstruction. However, its use may also be associated with an increased risk of injury to the contralateral ACL.

Purpose: To clarify the association between graft choice and the risk of revision and contralateral ACL reconstruction.

Rates of revision and surgeon-reported graft rupture following ACL reconstruction: early results from the New Zealand ACL Registry.

Purpose: There remains a lack of consensus on the patient factors associated with graft rupture following anterior cruciate ligament (ACL) reconstruction. This study aimed to identify the rate of revision and surgeon-reported graft rupture and clarify the patient risk factors for failure.

Methods: Analysis was conducted on prospective data captured by the New Zealand ACL registry.

Marked increase in the incidence of anterior cruciate ligament reconstructions in young females in New Zealand.

Background: Anterior cruciate ligament injuries cause significant morbidity, and may be increasing in incidence as participation in high-risk sports increases. The aim of this study is to investigate the incidence of anterior cruciate ligament reconstruction (ACLR) surgery in New Zealand, and to analyse changes over time in demographic subgroups.

Method: Data were sourced from the Accident Compensation Corporation.