Background:: Few population-based descriptive studies on the incidence of anterior cruciate ligament (ACL) reconstruction and concomitant pathology exist.
Hypothesis:: Incidence of ACL reconstruction has increased from 2002 to 2014.
Study Design:: Descriptive clinical epidemiology study.
Level Of Evidence:: Level 3.
Methods:: The Truven Health Analytics MarketScan Commercial Claims and Encounters database, which contains insurance enrollment and health care utilization data for approximately 158 million privately insured individuals younger than 65 years, was used to obtain records of ACL reconstructions performed between 2002 and 2014 and any concomitant pathology using Current Procedures Terminology (CPT) and International Classification of Diseases, Ninth Revision (ICD-9) codes. The denominator population was defined as the total number of person-years (PYs) for all individuals in the database. Annual rates were computed overall and stratified by age, sex, and concomitant procedure.
Results:: There were 283,810 ACL reconstructions and 385,384,623 PYs from 2002 to 2014. The overall rate of ACL reconstruction increased 22%, from 61.4 per 100,000 PYs in 2002 to 74.6 per 100,000 PYs in 2014. Rates of isolated ACL reconstruction were relatively stable over the study period. However, among children and adolescents, rates of both isolated ACL reconstruction and ACL reconstruction with concomitant meniscal surgery increased substantially. Adolescents aged 13 to 17 years had the highest absolute rates of ACL reconstruction, and their rates increased dramatically over the 13-year study period (isolated, +37%; ACL + meniscal repair, +107%; ACL + meniscectomy, +63%). Rates of isolated ACL reconstruction were similar for males and females (26.1 vs 25.6 per 100,000 PYs, respectively, in 2014), but males had higher rates of ACL reconstruction with concomitant meniscal surgery than females.
Conclusion:: Incidence rates of isolated ACL reconstruction and rates of concomitant meniscal surgery have increased, particularly among children and adolescents.
Clinical Relevance:: A renewed focus on adoption of injury prevention programs is needed to mitigate these trends. In addition, more research is needed on long-term patient outcomes and postoperative health care utilization after ACL reconstruction, with a focus on understanding the sex-based disparity in concomitant meniscal surgery.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204641 | PMC |
http://dx.doi.org/10.1177/1941738118803616 | DOI Listing |
An essential goal of the care that orthopaedic surgeons provide is improving outcomes in orthopaedic surgery. The use of nutritional interventions to improve outcomes has not been previously emphasized. It is important to focus on the types of nutritional interventions available and how they have been shown to affect the outcomes of treatment of fractures and elective procedures, including anterior cruciate ligament reconstruction and joint arthroplasty, with an emphasis on total shoulder arthroplasty.
View Article and Find Full Text PDFAm J Sports Med
January 2025
University of Kentucky, Department of Athletic Training and Clinical Nutrition, Lexington, Kentucky, USA.
Background: Patient-reported outcome (PROs) instruments of knee function quality of life are routinely administered to patients after anterior cruciate ligament reconstruction (ACLR). The Patient Acceptable Symptom State (PASS), an evidence-based threshold defining perceived outcomes, may be a useful indicator of strength and functional performance.
Purpose: To compare strength and functional performance between patients recovering from ACLR who did and did not meet PASS thresholds on associated PROs.
Am J Sports Med
January 2025
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA.
Background: Anterior cruciate ligament (ACL) injury often leads to posttraumatic osteoarthritis (PTOA), despite ACL reconstruction (ACLR). Medial meniscal extrusion (MME) is implicated in PTOA progression but remains understudied after ACL injury and ACLR.
Hypothesis/purpose: It was hypothesized that MME would increase longitudinally after ACL injury and ACLR, with greater changes in the ipsilateral knee compared with the contralateral knee, leading to cartilage degeneration.
Arthroscopy
December 2024
Orthopaedic Surgery Department - Aker, Oslo University Hospital, Oslo, Norway; University of Oslo, Oslo, Norway; Oslo Sports trauma research Center, Norwegian School of Sports Sciences, Oslo, Norway. Electronic address:
Am J Sports Med
January 2025
Memorial Hermann Rockets Sports Medicine Institute, Department of Sports Medicine & Rehabilitation, Houston, Texas, USA.
Background: Meniscal allograft transplantation (MAT) is indicated in the setting of anterior cruciate ligament (ACL) reconstruction to restore proper arthrokinematics and load distribution for the meniscus-deficient knee. Objective outcomes after ACL reconstruction with concomitant MAT in athletic populations are scarcely reported and highly variable.
Purpose: To compare patient outcomes using an objective functional performance battery, self-reported outcome measures, and return-to-sport rates between individuals undergoing ACL reconstruction with concomitant MAT and a matched group undergoing isolated ACL reconstruction.
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