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Patient demographic and surgical characteristics in anterior cruciate ligament reconstruction: a description of registries from six countries
  1. Heather A Prentice1,
  2. Martin Lind2,
  3. Caroline Mouton3,
  4. Andreas Persson4,5,
  5. Henrik Magnusson6,
  6. Ayman Gabr7,
  7. Romain Seil3,
  8. Lars Engebretsen4,5,
  9. Kristian Samuelsson8,
  10. Jon Karlsson8,
  11. Magnus Forssblad9,
  12. Fares S Haddad10,
  13. Tim Spalding11,
  14. Tadashi T Funahashi12,
  15. Liz W Paxton1,
  16. Gregory B Maletis13
  1. 1Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California, USA
  2. 2Division of Sports Surgery, Department of Orthopaedics, Aarhus University Hospital, Aarhus, Denmark
  3. 3Department of Orthopaedic Surgery, Clinique d’Eich-Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
  4. 4Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
  5. 5Norwegian Knee Ligament Registry, Orthopaedic Department, Haukeland University Hospital, Bergen, Norway
  6. 6Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  7. 7Trauma and Orthopaedic Department, University College London Hospitals, NHS Foundation Trust, London, UK
  8. 8Department of Orthopaedic Surgery, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
  9. 9Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
  10. 10Department of Trauma and Orthopaedics, University College London Hospitals, London, UK
  11. 11University Hospitals Coventry and Warwickshire (UHCW), Coventry, UK
  12. 12Department of Orthopaedics, Southern California Permanente Medical Group, Irvine, California, USA
  13. 13Department of Orthopaedics, Southern California Permanente Medical Group, Baldwin Park, California, USA
  1. Correspondence to Dr Heather A Prentice, Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA 92108, USA; heather.prentice{at}


Objective Findings from individual anterior cruciate ligament reconstruction (ACLR) registry studies are impactful, but how various registries from different countries compare with different patient populations and surgical techniques has not been described. We sought to describe six ACLR registry cohorts to understand variation across countries.

Methods Five European registries and one US registry participated. For each registry, all primary ACLR registered between registry establishment through 31December 2014 were identified. Descriptive statistics included frequencies, proportions, medians and IQRs. Revision incidence rates following primary ACLR were computed.

Results 101 125 ACLR were included: 21 820 in Denmark, 300 in Luxembourg, 17 556 in Norway, 30 422 in Sweden, 2972 in the UK and 28 055 in the US. In all six cohorts, males (range: 56.8%–72.4%) and soccer injuries (range: 14.1%–42.3%) were most common. European countries mostly used autografts (range: 93.7%–99.7%); allograft was most common in the US (39.9%). Interference screw was the most frequent femoral fixation in Luxembourg and the US (84.8% and 42.9%), and suspensory fixation was more frequent in the other countries (range: 43.9%–75.5%). Interference was the most frequent tibial fixation type in all six cohorts (range: 64.8%–98.2%). Three-year cumulative revision probabilities ranged from 2.8% to 3.7%.

Conclusions Similarities in patient demographics and injury activity were observed between all cohorts of ACLR. However, graft and fixation choices differed. Revision rates were low. This work, including >100 000 ACLR, is the most comprehensive international description of contemporary practice to date.

  • knee acl
  • epidemiology

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  • Funding None declared.

  • Competing interests FSH’s department receives research support and royalties from Smith & Nephew, Stryker, MatOrtho and Corin. None of these are directly linked to the current project. LE receives research grants from Smith & Nephew, Arthrex and Biomet/Zimmer. None of these grants are directly linked to the current project. JK is editor-in-chief of Knee Surgery, Sports Traumatology, Arthroscopy.

  • Ethics approval Each registry received approval from the National Board or Institutional Review Board prior to study commencement.

  • Provenance and peer review Not commissioned; externally peer reviewed.