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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Local Anaesthetic Infiltration (Lia) Is Equally Effective As Adductor Nerve Blocks For Pain Relief In Anterior Cruciate Ligament (Acl) Reconstructions. Abstract Presentation 8 minutes Mohammad Abou Salhab, MBChB, MSc, UNITED KINGDOM Sonal Sonwalkar , FRCA, UNITED KINGDOM Sanjeev Anand, MD, UNITED KINGDOM Martin Stone, MD, UNITED KINGDOM
Full-Thickness Peroneus Longus Tendon Autograft For Anterior Cruciate Ligament Reconstruction: Outcomes And Donor Site Morbidity ePoster Presentation Tarun Goyal, MBBS, MS, DNB, MCh, FRCS (Edin), INDIA Souvik Paul, MBBS, MS Orthopedics (AIIMS), DNB, MCh, Dip SICOT, INDIA Lakshmana Das Sekar, MS, DNB Orthopaedics, INDIA Arghya Kundu Choudhury, MS, MCh Joint replacement and reconstruction, INDIA
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
Predicting Patient Lost to Follow-up in the STABILITY 1 Study: A Multi-centre, International, Randomized Controlled Trial of Young, Active Patients Undergoing Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Andrew Firth, PhD, CANADA Dianne M. Bryant, PhD, CANADA Andrew Johnson, PhD, CANADA Stability Study Group, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Nerve injury during anterior cruciate ligament reconstruction: A comparison between patellar and hamstring tendon grafts harvest Abstract Presentation 5 minutes Jonathan Singer, MD, ISRAEL Ehud Rath, Prof., ISRAEL Mustafa Yassin, MD, ISRAEL Shlomo Bronak, MD, ISRAEL Barak Haviv, MD, ISRAEL
Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness? Abstract Presentation 5 minutes Etienne Deroche, MD, FRANCE Cécile Batailler, MD, PhD, FRANCE John Swan, MBBS, FRANCE Sebastien Lustig, MD, PhD, Prof., FRANCE Elvire Servien, MD, PhD, Prof., FRANCE
Risk Factor Analysis for Graft Failure after Anterior Cruciate Ligament Reconstruction with or without mLET Abstract Presentation 7 minutes Filip R Hendrikx, MD, BELGIUM Koen Lagae, MD, BELGIUM Annemieke Van Haver, PhD, MSc, BELGIUM Peter Verdonk, MD, PhD, BELGIUM
Relationship Between Posterior Tibial Slope And Sagittal Plane Mechanics During Jump Landing After Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Robert A. Duerr, MD, UNITED STATES Jennifer Perry, MS, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES Benjamin Ormseth, BS, UNITED STATES Robert Siston, PhD, UNITED STATES Andrew Garrone, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Laura C. Schmitt, PT, PhD, UNITED STATES
High Rate of Initially Overlooked Kaplan Fiber Complex Injuries in Patients With Isolated Anterior Cruciate Ligament Injury Abstract Presentation 5 minutes Ryan M Bell, BS, UNITED STATES Daniel P. Berthold, Association.-Prof., GERMANY Lukas Willinger, MD, GERMANY Matthew R. Levasseur, MD, UNITED STATES Daniel Marrero, MD, UNITED STATES Lukas Nawid Muench, MD, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Elmar Herbst, MD, PhD, GERMANY Mark P. Cote, PT, DPT, MSCTR, UNITED STATES Robert A. Arciero, MD, UNITED STATES Cory M. Edgar, MD, PhD, UNITED STATES
Impingement Due to Graft Buckling Is More Prevalent after ACL Reconstructions with an Adjustable-Loop Compared to a Fixed-Loop Abstract Presentation 5 minutes Julian De Rover, NETHERLANDS Inge Van Den Akker-Scheek, PhD, NETHERLANDS Hugo Christiaan van der Veen, MD, PhD, NETHERLANDS
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

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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