Page 40 - ISAKOS 2021 Newsletter Volume 1

CURRENT CONCEPTS
ACL Reconstruction 2020: A Worldwide Survey
ISAKOS Survey 2020
Asian Consensus 2016
Argentina Registry
North America: ACL Study Group Survey
Sweden Registry
UK Registry
New Zealand Registry
Percentage of lateral extra-articular tenodesis
Added in isolated primary ACL
10%
NA
NA
25% never, 59.4% rarely, 15.6% sometimes
0.6%
NA
NA
Added in revision ACL surgery
36%
NA
13.78%
19.35% never, 32.36% rarely, 32.26% sometimes, 16.13% often
6.80%
NA
NA
Average time to return to sports
9 months
NA
NA
> 6 months
NA
NA
NA
Indicated postoperative brace
55%
100%
NA
74%
NA
NA
NA
*NA = not available.
01 Trends in ACL Surgery
The goal of this survey was to delineate surgeons’ preferences for ACLR by summarizing the current trends around the globe. This large cohort also allowed for comparison of our results with those of regional registries and local surveys in order to highlight differences and similarities, as described below.
New Zealand ACL Registry
The New Zealand ACL Registry was successfully established nationwide in 2014, with the goal of recording all locally performed ACLR procedures. By 2019, this registry database had almost 10,000 patients. Surgeon participation is voluntary and currently captures approximately 75% of the estimated 3,000 ACLR procedures performed in the country annually. Patient-reported outcome measures (PROM) data (Knee Injury and Osteoarthritis Outcome [KOOS] and Marx scores) are collected from patients preoperatively and at 6 months, 1, 2, and 5 years, with the surgeon recording the intraoperative data immediately following the surgery and self-reporting any complications that arise in the following 5 years. Dataset completeness is high for the intraoperative data, but the young, mobile ACLR population makes long- term follow-up difficult everywhere. Here, the benefits of being a small island nation also come to the fore, with the 2-year follow-up rate of 70% comparing favorably to those of other mores established registries (~50%).
Similarities
A direct comparison between the NZ registry and the worldwide survey shows that the NZ experience is reasonably similar to the worldwide trends in terms of graft choice and drilling technique.
Hamstring autografts are the most common grafts (73.5% in NZ vs. 64% worldwide), followed by bone-patellar tendon- bone [BTB] grafts (21.4% in NZ vs. 21% worldwide).
38 ISAKOS NEWSLETTER 2021: VOLUME I