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Study highlights influence of information on surgeon practices to decrease ACL retears
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ORLANDO, Fla. — Research presented here indicated surgeons changed their practice patterns based on information about risk factors for retear after ACL reconstruction, which lead to a significant decrease in patients’ odds for retear.
Christopher C. Kaeding, MD, and colleagues analyzed data from two 2-year cohorts from the MOON study (2002-2003 and 2007-2008), both of which had a 2-year minimum follow-up, to determine whether a shift in clinical practice would occur after the analysis and publication of risk factors identified from the first, earlier cohort and, if a shift did occur, whether it would change the risk profile and rate of graft tears in the later cohort. The final study included a total of 1,758 patients who met all inclusion criteria.
Christopher C. Kaeding
“Allograft use in young, active patients increased the risk of graft tear in the early cohort. Upon dissemination of this information, surgeons changed allograft use to older patients — 30 years of age vs. 31 [years] — and less active patients [with a] Marx score of 8 vs. 11,” Kaeding said. “The only risk factor to change between the early and later cohorts was a decreased risk of allograft failure. The odds ratio for allograft failure decreased from 9.3 to 5.6.
“We feel this demonstrates that, when shown credible evidence of outcome predictors, surgeons change their practice patterns, which resulted in improved patient outcomes.”
The researchers found younger patient age, higher Marx activity scores and allograft use were identified as risk factors for ACL graft failure in both the early and late cohorts; however, patient sex was not identified as a risk factor of graft tear.
According to Kaeding, the earlier cohort had a graft failure rate of 11% in the 2-year follow-up period vs. 3% for the later cohort.
“The average age of the patients who did not tear was no different in the early and late cohorts, as was the average age of the patients who did tear. Similarly, the Marx activity score was no different for those who did not tear between early and late cohorts, as well as the average Marx for those who did tear in the early and late cohorts,” Kaeding added. – by Gina Brockenbrough, MA
Reference:
Kaeding CC, et al. Paper #1. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 9-12, 2015; Orlando, Fla.
Disclosure: Kaeding reports no relevant financial disclosures.