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Study Finds ACL Reconstruction on the Rise
Date:10/2/2009

tracked how many of these patients had any subsequent operation within one year or subsequent ACL reconstruction on either knee, among other factors. "The SPARCS database lets us look at a very large number of patients with longitudinal followup, so we can see what happens to them as opposed to just what happened during hospital admission. We can follow them for a few years," said Dr. Marx.

The researchers found that the frequency of subsequent surgery on either knee within one year was 6.5% (4,595 patients), and patients were more likely to have subsequent surgery if they were female or treated by a surgeon who performed a low volume of ACL surgeries.

"We know that a risk of an ACL tear is much higher in females, between two-to ten-fold, but this is the first study to show that women are at a higher risk of subsequent surgery after ACL reconstruction," Dr. Marx said.

Investigators also found that 1.9% (1,318 patients) of patients who underwent ACL reconstruction had a subsequent ACL reconstruction within one year. Patients were more likely to have a subsequent reconstruction if they were younger than age 40 and treated at a hospital that performed a low volume of ACL reconstructions.

"Younger patients under 40 are at a higher risk and that is likely related to the activity level. This has been my suspicion, but it hasn't been shown in a population this large before," explained Dr. Marx. "As we get older, as a group we tend to do less sports and high-risk activities, so people under 40 have a higher risk of needing more ACL surgery."

Dr. Marx said he was not surprised that volume was found to be a factor tied to outcomes. "I think that like everything in surgery and medicine, practice makes perfect and the more someone does something, the better their results are going to be," he said. "Volume like many things in medicine is a factor in ACL surgery." More than 800 ACL surgeries are performed each year at Ho
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SOURCE Hospital for Special Surgery
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