Summary: Although access to ACL reconstruction service has been improved over time, socio-economic barriers persist in utilization of ACL reconstruction in Alberta, Canada.

Background

Anterior Cruciate Ligament (ACL) injury is a common ligament injury, especially among young athletes and often requires surgical reconstruction. However, less is known about utilization of ACL reconstruction in Alberta, Canada.

Methods

We used a retrospective cohort design by linking administrative data from Alberta Health covering a period of 2010/11-2018/19. We used 2011 National household survey data to define neighborhood income quintile as a measure of socio-economic status (SES). We identified first emergency department (ED) visits due to ACL injury and followed up those with a diagnosis of ACL injury for a follow up period of 3 years to identify ACL reconstruction. The first primary ACL reconstruction on an individual was defined as an outcome measure. We used multivariable logistic regression to identify factors associated with ACL reconstruction (versus no reconstruction) adjusting for socio-demographic variables and season of injury diagnosis. Those with ACL injury after 1 April 2016, those with date of reconstruction earlier than date of ACL injury and those with more than 1 ACL reconstruction were excluded.

Results

A total of 12,965 participants with a diagnosis of ACL injury in ED between 2010/11 and 2015/16 were included in this analysis. Mean age of the participants was 32.7 years (SD:13.2 years). Males represented 58% of the cohort and nearly 15% were from rural areas.
Of the total ACL injuries, n=8193 (63.2%; 95% CI: 62.4%-64.0%) had an ACL reconstruction within three years from the date of the first ACL injury diagnosis. Multivariable logistic regression analysis revealed that age, sex, income quintile and season of injury diagnosis were independently associated with odds of undergoing ACL reconstruction within 3 years from diagnosis. Compared to those aged 40-49 years, those in 10-19 years (Odds Ratio 1.86,95% CI:1.6-2.0), 20-29 years (OR: 2.0, 95% CI:1.8-2.3) and 30-39 years (OR: 1.7, 95% CI:1.5-1.9) had a greater chances of ACL reconstruction. Whereas those aged 50-59 years (OR:0.4,95% CI:0.35-0.7), and 60 years and above (OR:0.08,95% CI:0.05-0.11) had a lower chance of ACL reconstruction. Females were more likely to have ACL reconstruction compared to males (OR:1.2,95% CI:1.1-1.3). Similarly, people living in the lower SES neighborhood were less likely to have ACL reconstruction compared to those living in the highest SES neighborhood. No difference was detected by urban/rural place of residence on utilization of ACL reconstruction. Having an ACL injury diagnosed in Spring (OR:1.1,95% CI:1.0-1.3) and Fall (OR:1.2,95% CI:1.1-1.4) was associated with higher chances of ACL reconstruction compared to those with ACL injury diagnosed in Summer.

Conclusion

Although access to and utilization of ACL reconstruction has improved over time, socioeconomic barriers persist in the utilization of ACL reconstruction. More research is needed to understand why population characteristics and season of injury diagnosis are associated with odds of ACL reconstruction.

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Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis Abstract Presentation 5 minutes Anthony Charles Mok, BS, UNITED STATES Andrew J Fancher, BS, UNITED STATES Matthew L Vopat, MD, UNITED STATES Jordan Charles Baker, BS, UNITED STATES Armin Tarakemeh, BS, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES Scott Mullen, MD, UNITED STATES Paul Schroeppel, MD, UNITED STATES Kimberly J. Templeton, MD, UNITED STATES Bryan Vopat, UNITED STATES
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Quadriceps Tendon Vs. Hamstring Tendon Autograft In Primary Anterior Cruciate Ligament Reconstruction: A Matched-Pairs Study With A Mean Follow-Up Of 6.5 Years Award Winner 5 minutes Armin Runer, PD MD, GERMANY Aline Suter, MD, AUSTRIA Tommaso Roberti di Sarsina, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Peter Gföller, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Robert Csapo, PhD, AUSTRIA Christian Fink, MD, Prof., AUSTRIA
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Pre-Operative Tunnel Widening Does Not Significantly Influence The Outcomes Of A Single-Stage Only Approach To Revision Acl Reconstruction: An Analysis Of 409 Consecutive Patients Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Charles Pioger, MD, FRANCE Johnny Rayes, MD, MSc, FEBOT, CANADA Ibrahim Haidar, MD, FRANCE Thomas Fradin, MD, FRANCE Cédric Ngbilo, MD, SWITZERLAND Thais Dutra Vieira, MD, FRANCE Etienne Cavaignac, MD,PhD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, FRANCE
Age, Time From Injury To Surgery And Quadriceps Strength Affect The Risk Of Revision Surgery After Primary Acl Reconstruction Abstract Presentation 6 minutes Riccardo Cristiani, MD, PhD, SWEDEN Magnus Forssblad, SWEDEN Gunnar Edman, MD, PhD, Prof., SWEDEN Karl Eriksson, MD, PhD, Prof., SWEDEN Anders Stalman, MD, PhD, associate professor, SWEDEN
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Acl - Pcl Fixation Sequence During Multi-Ligament Knee Reconstruction Does Not Affect Knee Laxity Abstract Presentation 6 minutes Carola F. van Eck, MD, PhD, FAAOS, UNITED STATES Aly Maher Fayed, MD, EGYPT Ryo Kanto, MD, JAPAN Taylor M. Price, MS, UNITED STATES Michael Dinenna, BS, UNITED STATES Monica A. Linde, MSIE, RN, UNITED STATES Patrick J. Smolinski, PhD, UNITED STATES
The Outcome Of Non-circular (Rectangle, Oval) Femoral Tunnel ACL Reconstruction, Does It Improve The Outcome Of ACL Reconstruction Surgery? Abstract Presentation 6 minutes S. Ali Ghasemi, MD, UNITED STATES Joseph McCahon, DO, UNITED STATES Arthur R Bartolozzi, MD, UNITED STATES
Coach Education Improves Implementation Of ACL Injury Prevention Programs: A Cluster-Randomized Controlled Trial Abstract Presentation 5 minutes Daphne Ling, PhD, MPH, TAIWAN Caroline Boyle, UNITED STATES Brandon Schneider, MS, UNITED STATES Joseph Janosky, DrPHc, MS, PT, ATC, UNITED STATES James Kinderknecht, UNITED STATES Robert G. Marx, MD, UNITED STATES
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Value, Limitations And Recommendations For Use Of Metal-Reduction Knee MRI Sequences Following Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Brandon Zhao, MD, CANADA Nabil Khan, MBChB, MMED, FCS Orth, CANADA Mark F. Sommerfeldt, MD, CANADA Anukul Panu, MD, CANADA Jacob L Jaremko, MD, PhD, CANADA Catherine May Ting Hui, MD, FRCSC, CANADA
The Lateral Femoral Notch Sign Entails Increased Rotatory Laxity After Acl-Injury. Pivot Shift Quantification With Surgical Navigation System Abstract Presentation 5 minutes Gian Andrea Lucidi, MD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Alberto Grassi, PhD, ITALY Luca Macchiarola, MD, ITALY Giacomo Dal Fabbro, MD, ITALY Nicola Pizza, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
PROSPECTIVE RANDOMIZED STUDY: Double-bundle against single-bundle ACL reconstruction using allografts Abstract Presentation 5 minutes Edmundo Berumen Nafarrate, PhD, Prof., MEXICO Carlos Alejandro Vega Najera, MD, MEXICO Joel Alejandro Cabral, MD, MEXICO Jesus Javier Tonche, MD, MEXICO Ivan Ramos Moctezuma, Eng, MEXICO Luis Sigala Gonzalez, Eng, MEXICO Avril Pérez Fontes, MD, MEXICO Fatima Quintana Trejo, Eng, MEXICO Carlos Leal, MD, Prof., COLOMBIA
Same Knee, Different Goals: Patients and Surgeons have Different Priorities Related to ACL Reconstructions and Surgeons are Resistant to Changing Clinical Practice Abstract Presentation 4 minutes Hana Marmura, BSc, CANADA Dianne M. Bryant, PhD, CANADA Trevor B. Birmingham, PT, PhD, CANADA Kurt Paul Spindler, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, CANADA
Lower Socioeconomic Status Adversely Affects Access To Care And The Rate Of Instability Events And Bucket Handle Meniscus Tears Following Anterior Cruciate Ligament Tears Abstract Presentation 6 minutes Edward S. Chang, MD, UNITED STATES Blake M. Bodendorfer, MD, UNITED STATES Andrew Curley, MD, UNITED STATES David X. Wang, MD, UNITED STATES Christine Conroy, MD, UNITED STATES Mark Hopkins, MD, UNITED STATES Brian McCormick, MD, UNITED STATES Caroline Fryar, MD, UNITED STATES
Tranexamic Acid Has No Effect On Post-Operative Hemarthrosis Or Pain Control Following Acl Reconstruction Using Bone Patella Tendon Bone Autograft: A Double-Blinded Randomized Control Trial Abstract Presentation 5 minutes Jordan W Fried, BM, UNITED STATES David Bloom, BA, UNITED STATES Eoghan T. Hurley, MB, BCh, MCh, IRELAND Samuel Baron, MD, UNITED STATES Kirk Anthony Campbell, MD, UNITED STATES Eric Jason Strauss, MD Laith M. Jazrawi, MD, UNITED STATES Michael J Alaia, MD, UNITED STATES
Dynamic Radiostereometry Evaluation Of Two Different Anterior Cruciate Ligament Reconstruction Techniques: Does Single Bundle Reconstruction Plus Lateral Plasty Cause Knee Over-Constraint? Abstract Presentation 4 minutes Alberto Grassi, PhD, ITALY Stefano Di Paolo, Eng, ITALY Piero Agostinone, MD, ITALY Gian Andrea Lucidi, MD, ITALY Erika Pinelly, MsC, ITALY Marco Bontempi, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
In Vivo Measurement of Anterior Cruciate Ligament Elongation and Strain Rate during Increasingly Demanding Activities ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Caiqi Xu, MD, CHINA Tom Gale, MS, UNITED STATES William Anderst, PhD, UNITED STATES Freddie H. Fu, MD, UNITED STATES
Bone Marrow Aspiration Concentrate Augmentation in Anterior Cruciate Ligament Hamstring Autograft Reconstruction: Clinical and Functional Outcomes of a Cohort Study Abstract Presentation 5 minutes David H. Figueroa, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Sergio Arellano, MD, CHILE Alex Vaisman, MD, Prof., CHILE Francisco Figueroa, MD, CHILE Nicolas Zilleruelo, MD, CHILE Rafael Calvo, MD, CHILE
Combined ACL and Anterolateral Ligament Reconstruction Confers Significantly Improved Long Term Outcomes when Compared to Isolated ACL Reconstruction: A Matched-Pair Analysis Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Ibrahim Haidar, MD, FRANCE Johnny Rayes, MD, MSc, FEBOT, CANADA Thomas Fradin, MD, FRANCE Cédric Ngbilo, MD, SWITZERLAND Benjamin Freychet, MD, FRANCE Thais Dutra Vieira, MD, FRANCE Herve Ouanezar, MD, UNITED ARAB EMIRATES Bertrand Sonnery-Cottet, MD, PhD, FRANCE

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Factors associated with anterior cruciate ligament (ACL) reconstruction among ACL injuries in Alberta, Canada

Factors associated with anterior cruciate ligament (ACL) reconstruction among ACL injuries in Alberta, Canada

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Factors associated with anterior cruciate ligament (ACL) reconstruction among ACL injuries in Alberta, Canada

Factors associated with anterior cruciate ligament (ACL) reconstruction among ACL injuries in Alberta, Canada

Background

Methods

Results

Conclusion

More ISAKOS 2021: Global Content