There is no such thing like a single ACL injury: Profiles of ACL-injured patients - 13/02/16

Doi : 10.1016/j.otsr.2015.11.007

R. Seil ^a,^b,^c,^⁎ , C. Mouton ^b,^c, A. Lion ^b,^c, C. Nührenbörger ^a, D. Pape ^a,^b,^c, D. Theisen ^b,^c
^a Sports Clinic, clinique d’Eich, Academic Teaching Hospital of the Saarland University Medical Centre, centre hospitalier de Luxembourg, 76, rue d’Eich, 1460 Luxembourg, Luxembourg
^b Sports Medicine Research Laboratory, Luxembourg Institute of Health, 76, rue d’Eich, 1460 Luxembourg, Luxembourg
^c Cartilage Net of the Greater Region Saar-Lor-Lux, Luxembourg, Luxembourg

^⁎Corresponding author. Sports Clinic, clinique d’Eich, Academic Teaching Hospital of the Saarland University Medical Centre, centre hospitalier de Luxembourg, 76, rue d’Eich, 1460 Luxembourg, Luxembourg.

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Abstract

Background

Current ACL registries rarely include non-operatively treated patients thus delivering an incomplete picture of the ACL-injured population. The aim of this study was to get an image of the population and treatment decision of an intrahospital registry. Our hypotheses were that patient-specific subtypes can be identified and that the percentage of operated patients differs between them.

Material and methods

Three hundred and forty-six operated and non-operated patients were included from March 2011 to December 2013. Standardized questionnaires allowed for data collection on gender, age, sports practice and previous ACL injuries. Chi-square tests allowed to compare these parameters between genders and age groups. A cluster analysis was computed to determine profiles of patients with similar characteristics.

Results

Three age groups were considered (I: ≤20; II: 21–35; III: ≥36 years). For males, the highest frequency of injuries was noted in group II with a greater proportion of injuries compared to females. In group III, more females were injured than males. Before injury, 54% patients were involved in competitive sports. Males were more likely to be injured in pivoting/contact sports before 35 and females during recreational skiing after 35. Twenty-one percent of the patients had had a previous ACL injury. The percentage of surgical treatment was superior to 80% in patients under 35 years involved in competitive sports, of 60–80% for those not involved in competitive sports and inferior to 60% for patients above 35 years.

Discussion

Systematic data collection allowed to identify specific subtypes of ACL-injured patient according to gender, age, previous ACL injury and preinjury level of practice. The decision-making process for or against ACL reconstructions at time of presentation depended on these characteristics. Consideration of these parameters will serve as a basis for an individualized treatment approach and a better understanding of patients at risk for ACL injuries.