Secondary surgeries 20 years after surgical and non-surgical treatment of ACL rupture: A population-based cohort study

Pernille Melbye; Per Hviid Gundtoft; Teodor Lien-Iversen; Daniel Barklin Morgan; Jens Christian Pörneki; Bjarke Viberg

doi:10.1016/j.knee.2022.01.007

Secondary surgeries 20 years after surgical and non-surgical treatment of ACL rupture: A population-based cohort study

Pernille Melbye, Per Hviid Gundtoft, Teodor Lien-Iversen, Daniel Barklin Morgan, Jens Christian Pörneki, Bjarke Viberg

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

2 Citations (Scopus)

Abstract

Background: Studies with less than 10 years of follow-up have demonstrated no difference between surgical and non-surgical treatment after an anterior cruciate ligament (ACL) rupture; however, long-term effects remain unclear. The aim of this study was to compare the risk of long-term secondary surgical procedures after primary surgical and non-surgical treatment for ACL ruptures. Methods: Patients aged 18–35, registered in the Danish National Patient Registry with an ACL rupture between January 1, 1996 and December 31, 2000 with a minimum of 20 years follow-up were included. The surgically treated group was defined as receiving an ACL reconstruction within 1 year after diagnosis. Major secondary surgical procedures were defined as subsequent ACL surgeries (reconstruction/revision), arthroplasty, deep infection, arthrodesis, or amputation. Minor secondary surgical procedures were defined as meniscal surgery, synovectomy, and manipulation under anesthesia (MUA). Multivariate regression analysis was performed to assess relative risk (RR), adjusted for age and sex. The results are reported with 95% confidence intervals. Results: 7,539 patients had an ACL rupture; 1,970 patients were surgically treated. In the surgically treated group, 5.9% of patients underwent major secondary surgeries; this was 6.1% in the non-surgically treated group, yielding an adjusted RR of 1.05 (0.85;1.30). There were 43.9% minor secondary surgeries in the surgically treated group and 49.1% in the non-surgically treated group, yielding an adjusted RR of 1.29 (1.20;1.39). Conclusions: No significant differences in the rate of major secondary surgical procedures between the groups, the non-surgical group was associated with a higher risk of minor secondary surgeries.

Original language	English
Journal	Knee
Volume	35
Pages (from-to)	1-7
Number of pages	7
ISSN	0968-0160
DOIs	https://doi.org/10.1016/j.knee.2022.01.007
Publication status	Published - 1 Mar 2022
Externally published	Yes

Keywords

ACL
ACL reconstruction
ACL rupture
Knee ligaments
National registry
Non-surgical treatment
Secondary surgeries

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10.1016/j.knee.2022.01.007

Cite this

@article{9be194ab53d34567bfac636b7c5f4015,

title = "Secondary surgeries 20 years after surgical and non-surgical treatment of ACL rupture: A population-based cohort study",

abstract = "Background: Studies with less than 10 years of follow-up have demonstrated no difference between surgical and non-surgical treatment after an anterior cruciate ligament (ACL) rupture; however, long-term effects remain unclear. The aim of this study was to compare the risk of long-term secondary surgical procedures after primary surgical and non-surgical treatment for ACL ruptures. Methods: Patients aged 18–35, registered in the Danish National Patient Registry with an ACL rupture between January 1, 1996 and December 31, 2000 with a minimum of 20 years follow-up were included. The surgically treated group was defined as receiving an ACL reconstruction within 1 year after diagnosis. Major secondary surgical procedures were defined as subsequent ACL surgeries (reconstruction/revision), arthroplasty, deep infection, arthrodesis, or amputation. Minor secondary surgical procedures were defined as meniscal surgery, synovectomy, and manipulation under anesthesia (MUA). Multivariate regression analysis was performed to assess relative risk (RR), adjusted for age and sex. The results are reported with 95% confidence intervals. Results: 7,539 patients had an ACL rupture; 1,970 patients were surgically treated. In the surgically treated group, 5.9% of patients underwent major secondary surgeries; this was 6.1% in the non-surgically treated group, yielding an adjusted RR of 1.05 (0.85;1.30). There were 43.9% minor secondary surgeries in the surgically treated group and 49.1% in the non-surgically treated group, yielding an adjusted RR of 1.29 (1.20;1.39). Conclusions: No significant differences in the rate of major secondary surgical procedures between the groups, the non-surgical group was associated with a higher risk of minor secondary surgeries.",

keywords = "ACL, ACL reconstruction, ACL rupture, Knee ligaments, National registry, Non-surgical treatment, Secondary surgeries",

author = "Pernille Melbye and {Hviid Gundtoft}, Per and Teodor Lien-Iversen and {Barklin Morgan}, Daniel and P{\"o}rneki, {Jens Christian} and Bjarke Viberg",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s)",

year = "2022",

month = mar,

day = "1",

doi = "10.1016/j.knee.2022.01.007",

language = "English",

volume = "35",

pages = "1--7",

journal = "Knee",

issn = "0968-0160",

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Secondary surgeries 20 years after surgical and non-surgical treatment of ACL rupture: A population-based cohort study. / Melbye, Pernille; Hviid Gundtoft, Per; Lien-Iversen, Teodor et al.
In: Knee, Vol. 35, 01.03.2022, p. 1-7.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Secondary surgeries 20 years after surgical and non-surgical treatment of ACL rupture: A population-based cohort study

AU - Melbye, Pernille

AU - Hviid Gundtoft, Per

AU - Lien-Iversen, Teodor

AU - Barklin Morgan, Daniel

AU - Pörneki, Jens Christian

AU - Viberg, Bjarke

PY - 2022/3/1

Y1 - 2022/3/1

N2 - Background: Studies with less than 10 years of follow-up have demonstrated no difference between surgical and non-surgical treatment after an anterior cruciate ligament (ACL) rupture; however, long-term effects remain unclear. The aim of this study was to compare the risk of long-term secondary surgical procedures after primary surgical and non-surgical treatment for ACL ruptures. Methods: Patients aged 18–35, registered in the Danish National Patient Registry with an ACL rupture between January 1, 1996 and December 31, 2000 with a minimum of 20 years follow-up were included. The surgically treated group was defined as receiving an ACL reconstruction within 1 year after diagnosis. Major secondary surgical procedures were defined as subsequent ACL surgeries (reconstruction/revision), arthroplasty, deep infection, arthrodesis, or amputation. Minor secondary surgical procedures were defined as meniscal surgery, synovectomy, and manipulation under anesthesia (MUA). Multivariate regression analysis was performed to assess relative risk (RR), adjusted for age and sex. The results are reported with 95% confidence intervals. Results: 7,539 patients had an ACL rupture; 1,970 patients were surgically treated. In the surgically treated group, 5.9% of patients underwent major secondary surgeries; this was 6.1% in the non-surgically treated group, yielding an adjusted RR of 1.05 (0.85;1.30). There were 43.9% minor secondary surgeries in the surgically treated group and 49.1% in the non-surgically treated group, yielding an adjusted RR of 1.29 (1.20;1.39). Conclusions: No significant differences in the rate of major secondary surgical procedures between the groups, the non-surgical group was associated with a higher risk of minor secondary surgeries.

AB - Background: Studies with less than 10 years of follow-up have demonstrated no difference between surgical and non-surgical treatment after an anterior cruciate ligament (ACL) rupture; however, long-term effects remain unclear. The aim of this study was to compare the risk of long-term secondary surgical procedures after primary surgical and non-surgical treatment for ACL ruptures. Methods: Patients aged 18–35, registered in the Danish National Patient Registry with an ACL rupture between January 1, 1996 and December 31, 2000 with a minimum of 20 years follow-up were included. The surgically treated group was defined as receiving an ACL reconstruction within 1 year after diagnosis. Major secondary surgical procedures were defined as subsequent ACL surgeries (reconstruction/revision), arthroplasty, deep infection, arthrodesis, or amputation. Minor secondary surgical procedures were defined as meniscal surgery, synovectomy, and manipulation under anesthesia (MUA). Multivariate regression analysis was performed to assess relative risk (RR), adjusted for age and sex. The results are reported with 95% confidence intervals. Results: 7,539 patients had an ACL rupture; 1,970 patients were surgically treated. In the surgically treated group, 5.9% of patients underwent major secondary surgeries; this was 6.1% in the non-surgically treated group, yielding an adjusted RR of 1.05 (0.85;1.30). There were 43.9% minor secondary surgeries in the surgically treated group and 49.1% in the non-surgically treated group, yielding an adjusted RR of 1.29 (1.20;1.39). Conclusions: No significant differences in the rate of major secondary surgical procedures between the groups, the non-surgical group was associated with a higher risk of minor secondary surgeries.

KW - ACL

KW - ACL reconstruction

KW - ACL rupture

KW - Knee ligaments

KW - National registry

KW - Non-surgical treatment

KW - Secondary surgeries

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U2 - 10.1016/j.knee.2022.01.007

DO - 10.1016/j.knee.2022.01.007

M3 - Journal article

SN - 0968-0160

VL - 35

SP - 1

EP - 7

JO - Knee

JF - Knee

ER -

Secondary surgeries 20 years after surgical and non-surgical treatment of ACL rupture: A population-based cohort study

Abstract

Keywords

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