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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Adding A Lateral Extra-Articular Tenodesis Significantly Reduces Acl Graft Rupture Rates In Pediatric And Adolescent Patients When Compared To Isolated Acl Reconstruction Abstract Presentation 5 minutes Andrea Ferretti, Prof., ITALY Adnan Saithna, MD, FRCS, UNITED STATES Alessandro Carrozzo, MD, ITALY Alessandro Annibaldi, MD, ITALY Fabio Marzilli, MD, ITALY Edoardo Monaco, MD, ITALY
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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, LEBANON Thomas Fradin, MD, FRANCE Cédric Ngbilo, MD, SWITZERLAND Thais Dutra Vieira, MD, FRANCE Etienne Cavaignac, MD,PhD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, 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
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Quantitative Evaluation of Lateral Articular Cartilage Quality on Magnetic Resonance Imaging at 2-years following Anterior Cruciate Ligament Reconstruction With Or Without A Lateral Extra-Articular Tenodesis Abstract Presentation 6 minutes Andrew Firth, PhD, CANADA Dianne M. Bryant, PhD, CANADA Jaques Milner , CANADA Stephany Pritchett, MD, FRCPC, DABR, CANADA David Holdsworth, PhD, Canada Stability Study Group, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
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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
The Effect of Lateral Extra-Articular Tenodesis on Medial and Lateral Menisci Loading in Response To Simulated Tests of the Pivot Shift and Anterior Laxity Abstract Presentation 6 minutes Niv Marom, MD, ISRAEL Hamid Jahandar, BS, UNITED STATES Zaid Zayyad, MD, MS, UNITED STATES thomas fraychineaud, MD, UNITED STATES Herve Ouanezar, MD, UNITED ARAB EMIRATES Ronak M. Patel, MD, UNITED STATES Carl W Imhauser, PhD, UNITED STATES Thomas L. Wickiewicz, MD, UNITED STATES Andrew D. Pearle, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), 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
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Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
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
Analysis Of The Blood Supply To The Femoral Attachment Of The Anterior Cruciate Ligament After Acl Injury Abstract Presentation 4 minutes Jedrzej Jerzy Lesman, PhD MD, POLAND Marcin E. Domzalski, MD, Prof., POLAND Krzysztof Nowak, MD, PhD, POLAND Sebastian Zygmunt Żabierek, PhD, POLAND Radoslaw Grabowski, MD, POLAND Ilona Wagner-Olszewska, MD, POLAND
Negative Effects Of Delayed Anterior Cruciate Ligament Reconstruction On Associated Injuries And Knee Laxity Abstract Presentation 6 minutes Riccardo Cristiani, MD, PhD, SWEDEN Per-Mats Janarv, MD, PhD, Associate Prof., SWEDEN Bjorn Engstrom, MD, PhD, Assoc. Prof., SWEDEN Gunnar Edman, MD, PhD, Prof., SWEDEN Magnus Forssblad, SWEDEN Anders Stalman, MD, PhD, Associate Professor, SWEDEN
Posterior Tibial Plateau Impaction Fractures Are Not Associated With Increased Knee Instability: A Quantitative Pivot Shift Analysis Abstract Presentation 8 minutes Brian M Godshaw, MD, UNITED STATES Joshua C Setliff, BA, UNITED STATES Jonathan D Hughes, MD, PhD, UNITED STATES Volker Musahl, MD, Prof., 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
PSM: Pivot Shift Meter Cellphone Application for Classifying ACL Injuries Abstract Presentation 5 minutes Edmundo Berumen Nafarrate, PhD, Prof., MEXICO Carlos Alejandro Vega Najera, MD, MEXICO Joel Alejandro Cabral, MD, MEXICO Luis Sigala Gonzalez, Eng, MEXICO Ivan Ramos Moctezuma, Eng, MEXICO Carlos Leal, MD, Prof., COLOMBIA Jesus Javier Tonche, MD, MEXICO Avril Pérez Fontes, MD, MEXICO Fatima Quintana Trejo, Eng, MEXICO
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
Ligamentous Laxity, Male Sex, Chronicity, Meniscus Injury And Posterior Tibial Slope Are Associated With A High-Grade Pre-Operative Pivot Shift: A Post Hoc Analysis Of The Stability Study Abstract Presentation 6 minutes Lachlan Batty, FRACS, AUSTRALIA Andrew Firth, PhD, CANADA Gilbert Moatshe, MD, PhD, NORWAY Dianne M. Bryant, PhD, CANADA S. Mark A. Heard, MD, FRCS, CANADA Robert G. McCormack, MD, CANADA Alex Rezansoff, MD, FRCSC, CANADA Devin Clarke Peterson, MD, FRCSC, Dip Sport Med, CANADA Davide Bardana, MD, CANADA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Creating A Crosswalk For Knee Outcomes After ACLR From The KOOS(5) To The IKDC-SKF Abstract Presentation 6 minutes Jessica L. Johnson, DPT, PhD, UNITED STATES Aaron Boulton, PhD, UNITED STATES Kurt Paul Spindler, MD, UNITED STATES Laura J. Huston, MS, UNITED STATES Tim Spalding, FRCS(Orth), UNITED KINGDOM Laura Asplin, UNITED KINGDOM May Arna Risberg, PT, PhD, NORWAY Lynn Snyder-Mackler, PT, ScD, FAPTA, UNITED STATES
The Effect Of Lateral Extraarticular Tenodesis On In Vivo Cartilage Contact In Combined Anterior Cruciate Ligament Reconstruction ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Tom Gale, MS, UNITED STATES Daisuke Chiba, MD, PhD, JAPAN Felipe Martin Suntaxi, MS, UNITED STATES Bryson P. Lesniak, MD, UNITED STATES Freddie H. Fu, MD, UNITED STATES William Anderst, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES

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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