Epidemiology of Anterior Cruciate Ligament Reconstruction in Brazil's Public Health System

Lopes, Thiago Jambo Alves; Simić, Milena; Pappas, Evangelos

doi:10.1590/1517-869220162204159074

Cited by 21 publications

(19 citation statements)

References 23 publications

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“…The authors also identified a significant increase in total admission costs per case. Lopes et al[ 27 ] evaluated the epidemiology of ACLR in the Brazilian public health system and reported an average length of stay of 1.8 days in 2014. In the same study, the authors showed a reduction in hospital length of stay over several years.…”

Section: Discussionmentioning

confidence: 99%

Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

et al. 2018

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PurposeThe aims of this study are to describe the epidemiological characteristics of anterior cruciate ligament reconstructions in a private hospital in Brazil and to determine trends in medical practice for comparison with previous studies.MethodsWe retrospectively reviewed the anterior cruciate ligament institutional register to obtain data from all patients who underwent primary anterior cruciate ligament reconstruction from July 2014 to June 2016. Descriptive statistics were used to summarize the sample. Specific statistical tests were used to assess associations between the meniscal lesion and other variables.ResultsDuring the study period, 72.6% out of 500 patients were male. The mean age at surgery was 35.1 years. The mean age was higher among females than among males (37.3 ± 12.1 vs 34.3 ± 10.8 years). The median time from injury to surgery was 44 days. The most common femoral and tibial fixations used were suspensory fixation (60.8%) and interference screw (96%), respectively. The most commonly used graft was hamstring tendon (70.2%), followed by bone-patellar tendon-bone (28.8%). A meniscal lesion was noted in 44.8% of cases. Partial meniscectomy was performed in 69.5% of meniscal lesions, and meniscal repair was performed in 14.1% of lesions. The mean length of hospital stay was 1.4 days. The proportion of men in the group of patients with an associated meniscal lesion was higher than that in the group of patients without a meniscal lesion (p = 0.007).ConclusionsIn this study, we identified that the vast majority of surgeries were performed in male patients in all age groups, and patients older than 30 years and with a short time from injury to surgery predominated. Concerning surgical technique, we noted a low rate of meniscal repair and a higher preference for the use of hamstring graft and suspensory fixation on the femoral side.

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Section: Discussionmentioning

confidence: 99%

Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

et al. 2018

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“…11 A similar male predominance (M:F, 1.5:1) among Indian such patients has been reported by Gupta et al in 2014. 10 Lopes et al (2016) reported a male to female ratio of 4.6:1 in Brazilian such patients 12 while Abd Razak et al reported it to be 4.9:1 in Singapore. 13 In the present study, the mean BMI of the patients was 27.35±4.24 Kg/m 2 .…”

Section: Discussionmentioning

confidence: 98%

Positive Predictive Value of the Lelli’s Test in Diagnosing Anterior Cruciate Ligament Injury taking Arthroscopic Findings as Gold Standard

Jawad

Javid

Ahmad

et al. 2020

APMC

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Background: Arthroscopic examination is the gold standard for diagnosing ACL injury. However, it is an invasive procedure and is only performed in patients with strong clinical suspicion of ACL injury. Among the various clinical methods for the assessment of ACL injury, Lachman, anterior drawer and pivot shift tests are used in routine practice. But all these tests have their own limitations and have very low positive predictive value. Lelli's test, a recently introduced clinical test has been shown to be superior to these existing tests. It carries a high positive predictive value and can be performed easily in routine clinical setup without any known limitation. However, the available evidence on the positive predictive value of Lelli's test was limited. Objective: To determine the positive predictive value of the Lelli's test in diagnosing anterior cruciate ligament injury taking arthroscopic findings as gold standard. Study Design: Cross Sectional Study. Settings: The study was conducted in Department of Orthopedic Surgery, Services Hospital Lahore. Duration: 6 months from approval of this study 11-01-2017 to 10-07-2017. Methodology: This study involved 197 patients of both genders aged between 20-45 years suspected of ACL tear and having a positive Lelli's test on clinical examination. Arthroscopy was performed in all these patients to determine the presence or absence of ACL tear. The results of arthroscopy were taken as gold standard. Outcome variable was positive predictive value of Lelli's test which was noted and compared among various age, gender, BMI and duration of symptoms groups. Results: Mean age was 32.82±7.61 years. The mean duration of symptoms was 5.03±2.13 weeks while the mean BMI was 27.35±4.24 Kg/m 2 .Arthroscopy confirmed ACL injury in 175 (88.8%) patients. Thus, there were 175 true positive and 22 false positive cases which yielded a positive predictive value of 88.8% for Lelli's test in diagnosing ACL tear taking arthroscopy as gold standard. Conclusion: The positive predictive value of Lelli's test was found to be 88.8% in diagnosing ACL tear taking arthroscopy as gold standard. It was not affected by patient's age, gender, BMI and duration of symptoms which make it superior to other clinical tests currently in practice.

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“…The results of this study support the efficacy of the hemostatic capacity of the bi-component to prevent the spread of bleeding as well as increase its residual absorption in the immediate postoperative period. Electrocautery is one of the most common methods of achieving hemostasis (1). However, by performing electrocautery of the tissues, surgeons cause carbonization, that is, we controlled the bleeding by damaging the tissue around it.…”

Section: Discussionmentioning

confidence: 99%

“…Despite being a highly popular graft choice, the comorbidities resulting from the harvest of gracilis and semitendinosus muscle tendons to the anterior cruciate ligament (ACL) reconstruction are a substantial source of patient morbidity and disturb rehabilitation in the early postoperative period (1,2).…”

Section: Introductionmentioning

confidence: 99%

The efficacy of bi-component carboxymethylcellulose-polysaccharide B as a hemostatic and anti-adherent agent at the tibial insertion of the hamstring tendons after reconstruction of the anterior cruciate ligament

Astur

Baras

Chaim

et al. 2019

Muscle Ligaments and Tendons J

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Objective. The objective of this study is to evaluate and compare hemostatic and anti-adherent efficacy of the bi-component carboxymethylcellulose-polysaccharide B to the standard of electocauterization at the gracilis and semitendinosis harvest site in patients undergoing anterior cruciate ligament (ACL) reconstruction. Methods. In this randomized control trial, 32 patients undergoing ACL reconstruction were randomly divided into two groups. In group 1 (control), hemostasis was achieved via electrocoagulation at the gracilis and semitendinosis harvest site, and in group 2 (intervention) the bi-component was used to control bleeding at the same site. Results. There was no statistical difference between the groups in the pain assessments postoperatively, and the patients in group 2 had lower incidence of hematoma than the patients in group 1 on the first day postoperatively. There was a statistically significant difference between the groups in terms of postoperative range of motion (ROM) during the study period (p = 0.022). Patients in group 1 gained 17.8 degrees, patients in group 2 increased ROM by 34 degrees. No statistically significant difference was found in the incidence of hypoesthesia between the groups (p = 0.870). Conclusion. Bi-component carboxymethylcellulose-polysaccharide B showed better outcomes in terms of hematoma prevention and postoperative ROM than standard electrocoagulation in the immediate postoperative period for patients undergoing ACL reconstruction. Surgeons should consider using this compound to achieve hemostasis at the gracilis and semitendinosis harvest site during ACL reconstruction.

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Epidemiology of Anterior Cruciate Ligament Reconstruction in Brazil's Public Health System

Cited by 21 publications

References 23 publications

Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register

Positive Predictive Value of the Lelli’s Test in Diagnosing Anterior Cruciate Ligament Injury taking Arthroscopic Findings as Gold Standard

The efficacy of bi-component carboxymethylcellulose-polysaccharide B as a hemostatic and anti-adherent agent at the tibial insertion of the hamstring tendons after reconstruction of the anterior cruciate ligament

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