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Contemporary Practice Patterns for the Treatment of Anterior Cruciate Ligament Tears in the United States
BACKGROUND: There is a lack of research investigating current practice trends in the treatment of anterior cruciate ligament (ACL) tears as well as common concomitant procedures and reoperations associated with ACL reconstruction (ACLR). PURPOSE: To analyze current practice patterns for ACLR as well...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485167/ https://www.ncbi.nlm.nih.gov/pubmed/34604433 http://dx.doi.org/10.1177/23259671211040891 |
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author | Cevallos, Nicolas Soriano, Kylen K.J. Lansdown, Drew A. Ma, C. Benjamin Feeley, Brian T. Zhang, Alan L. |
author_facet | Cevallos, Nicolas Soriano, Kylen K.J. Lansdown, Drew A. Ma, C. Benjamin Feeley, Brian T. Zhang, Alan L. |
author_sort | Cevallos, Nicolas |
collection | PubMed |
description | BACKGROUND: There is a lack of research investigating current practice trends in the treatment of anterior cruciate ligament (ACL) tears as well as common concomitant procedures and reoperations associated with ACL reconstruction (ACLR). PURPOSE: To analyze current practice patterns for ACLR as well as the frequency of concomitant and revision procedures with respect to patient characteristics in a cross-sectional population of the United States. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Patient data between 2010 and 2017 were queried using the Mariner PearlDiver database. International Classification of Diseases, Ninth Revision (in 2010-2014) and Tenth Revision (ICD-10; in 2015-2017), diagnosis codes were used to identify ACL tears, and Current Procedural Terminology codes were used to identify ACLR and concomitant surgical procedures. Patient characteristics were stratified by sex and age. Cases of subsequent knee surgery and conversion to total knee arthroplasty (TKA) within 2 years after ACLR were tracked using ICD-10 codes between 2015 and 2017 to ensure ipsilateral laterality. RESULTS: Of 229,295 patients identified with an ACL tear diagnosis during the study period, 75% underwent ACLR. In patients aged 10 to 39 years, 84% to 92% underwent ACLR, while patients aged 50 to 59 (50%) and 60 to 69 (28%) years were less likely to have surgery after an ACL tear. Female and male patients underwent ACLR at a similar rate (75%). Within the patients who underwent ACLR, 44% underwent concomitant meniscal debridement as compared with 11% with concomitant meniscal repair. Male patients were more likely to undergo meniscal debridement (48% vs 40%; P < .0001). The frequency of meniscal repair increased from 9% in 2010 to 14% in 2017, while the frequency of meniscal debridement decreased from 47% to 41% (P < .0001). Within 2 years of ACLR, 6% of patients underwent revision ACLR; 4%, subsequent meniscal debridement; 1%, meniscal repair; and 1%, conversion to TKA. CONCLUSION: The frequency of ACLR for ACL tears has remained relatively stable in recent years and was similar between female and male patients in this cross-sectional population. The majority of patients aged 10 to 39 years underwent ACLR, while less than half of patients >50 years underwent surgery. |
format | Online Article Text |
id | pubmed-8485167 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-84851672021-10-02 Contemporary Practice Patterns for the Treatment of Anterior Cruciate Ligament Tears in the United States Cevallos, Nicolas Soriano, Kylen K.J. Lansdown, Drew A. Ma, C. Benjamin Feeley, Brian T. Zhang, Alan L. Orthop J Sports Med Article BACKGROUND: There is a lack of research investigating current practice trends in the treatment of anterior cruciate ligament (ACL) tears as well as common concomitant procedures and reoperations associated with ACL reconstruction (ACLR). PURPOSE: To analyze current practice patterns for ACLR as well as the frequency of concomitant and revision procedures with respect to patient characteristics in a cross-sectional population of the United States. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Patient data between 2010 and 2017 were queried using the Mariner PearlDiver database. International Classification of Diseases, Ninth Revision (in 2010-2014) and Tenth Revision (ICD-10; in 2015-2017), diagnosis codes were used to identify ACL tears, and Current Procedural Terminology codes were used to identify ACLR and concomitant surgical procedures. Patient characteristics were stratified by sex and age. Cases of subsequent knee surgery and conversion to total knee arthroplasty (TKA) within 2 years after ACLR were tracked using ICD-10 codes between 2015 and 2017 to ensure ipsilateral laterality. RESULTS: Of 229,295 patients identified with an ACL tear diagnosis during the study period, 75% underwent ACLR. In patients aged 10 to 39 years, 84% to 92% underwent ACLR, while patients aged 50 to 59 (50%) and 60 to 69 (28%) years were less likely to have surgery after an ACL tear. Female and male patients underwent ACLR at a similar rate (75%). Within the patients who underwent ACLR, 44% underwent concomitant meniscal debridement as compared with 11% with concomitant meniscal repair. Male patients were more likely to undergo meniscal debridement (48% vs 40%; P < .0001). The frequency of meniscal repair increased from 9% in 2010 to 14% in 2017, while the frequency of meniscal debridement decreased from 47% to 41% (P < .0001). Within 2 years of ACLR, 6% of patients underwent revision ACLR; 4%, subsequent meniscal debridement; 1%, meniscal repair; and 1%, conversion to TKA. CONCLUSION: The frequency of ACLR for ACL tears has remained relatively stable in recent years and was similar between female and male patients in this cross-sectional population. The majority of patients aged 10 to 39 years underwent ACLR, while less than half of patients >50 years underwent surgery. SAGE Publications 2021-09-24 /pmc/articles/PMC8485167/ /pubmed/34604433 http://dx.doi.org/10.1177/23259671211040891 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Cevallos, Nicolas Soriano, Kylen K.J. Lansdown, Drew A. Ma, C. Benjamin Feeley, Brian T. Zhang, Alan L. Contemporary Practice Patterns for the Treatment of Anterior Cruciate Ligament Tears in the United States |
title | Contemporary Practice Patterns for the Treatment of Anterior Cruciate
Ligament Tears in the United States |
title_full | Contemporary Practice Patterns for the Treatment of Anterior Cruciate
Ligament Tears in the United States |
title_fullStr | Contemporary Practice Patterns for the Treatment of Anterior Cruciate
Ligament Tears in the United States |
title_full_unstemmed | Contemporary Practice Patterns for the Treatment of Anterior Cruciate
Ligament Tears in the United States |
title_short | Contemporary Practice Patterns for the Treatment of Anterior Cruciate
Ligament Tears in the United States |
title_sort | contemporary practice patterns for the treatment of anterior cruciate
ligament tears in the united states |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485167/ https://www.ncbi.nlm.nih.gov/pubmed/34604433 http://dx.doi.org/10.1177/23259671211040891 |
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