Affiliation:
1. Department of Surgery, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
2. Forte Sports Christchurch New Zealand
3. Department of Orthopaedic Surgery Middlemore Hospital Auckland New Zealand
4. Department of Orthopaedic Surgery North Shore Hospital Auckland New Zealand
Abstract
AbstractPurposeTo validate the New Zealand Anterior Cruciate Ligament (ACL) Registry's capture rate of revisions by cross‐referencing Registry data with reoperations data recorded by the Accident Compensation Corporation (ACC) and identify risk factors for all‐cause reoperation.MethodsPrimary ACL reconstructions performed between April 2014 and September 2019 were individually matched on a record‐by‐record basis between the two databases. The ACC database was used to identify patients who underwent a reoperation with manual review of operation notes to identify whether a revision or other procedure was performed. This was combined with the number of revisions separately recorded in the New Zealand ACL Registry, which was used as the denominator value to calculate the Registry's capture rate of revisions. Patient and surgical data recorded in the Registry were analysed to identify independent predictors for all‐cause reoperation.ResultsA total of 8046 primary ACL reconstructions were matched between the New Zealand ACL Registry and the ACC databases. The reoperation rate was 8.9% (n = 715) at a mean follow‐up of 2.5 years. Meniscal‐related procedures were the most common reoperation (n = 299, 3.7%), followed by revision ACL reconstruction (n = 219, 2.7%), arthrofibrosis (n = 185, 2.3%), cartilage (n = 56, 0.7%) and implants (n = 32, 0.4%). The New Zealand ACL Registry captured 96% of revisions. Younger age (hazard ratio [HR] > 1.4, p < 0.001), earlier surgery (HR > 1.3, p = 0.05), concurrent meniscal repair (medial meniscus HR = 1.9, p < 0.001 and lateral meniscus HR = 1.3, p = 0.022) and hamstring tendon autografts (HR = 1.4, p = 0.001) were associated with a higher risk of reoperation.ConclusionThe New Zealand ACL Registry captured 96% of revisions. Risk factors for all‐cause reoperation included younger age, earlier surgery, meniscal repair and hamstring tendon autografts.Level of EvidenceLevel III.