High incidence and costs for anterior cruciate ligament reconstructions performed in Australia from 2003–2004 to 2007–2008: time for an anterior cruciate ligament register by Scandinavian model?

Abstract

The aim of this paper was to provide a descriptive epidemiology of anterior cruciate ligament (ACL) reconstructions in Australia. Data on all ACL reconstructions were collected from July 1, 2003 till June 30, 2008. Main outcome measures were the incidence of ACL reconstructions for Australia, per age group, sex and sport, including estimates of direct costs. There were 50 187 ACL reconstructions over the 5-year period studied. The population-based incidence of ACL reconstructions per 100 000 person-years was 52.0 [95% confidence intervals (CI): 51.6; 52.5], higher than previously published incidences from other western countries (Scandinavia 32-38). The population incidence rose rapidly through adolescence and early adulthood and then gradually declined. Males had a higher population incidence than females. Skiing had the highest incidence of ACL reconstructions per 100 000 person-years, followed by Australian rules football, rugby, netball and soccer. The total estimated hospital costs associated with ACL reconstruction surgery were over A$75 million (€45 million) per year. Further research is necessary to examine the causes for the higher population incidence of ACL reconstructions in Australia compared with other countries. The establishment of a national register of ACL injuries, similar to those developed in Scandinavia should be considered.

Long-term quality of life following anterior cruciate ligament injury and reconstruction

“…International data show that the incidence of ACLR is over twice as high in adolescents and adults younger than 39 years and female athletes experience higher rates of ACL rupture than their male counterparts (Granan et al, 2008;Granan et al, 2009;Janssen et al, 2012;Joseph et al, 2013;Lind et al, 2009).…”

“…In the United States, the incidence of ACLR has been estimated at 30 per 100,000 inhabitants (Csintalan, 2008). In Australia, the estimated incidence rate of ACLR is higher at 52 per 100,000 inhabitants, using data from a national hospital administrative database (Janssen, Orchard, Driscoll, & van Mechelen, 2012).…”

“…The impact of living with knee difficulties on the QOL of previously active ACL-reconstructed individuals is poorly understood. Considering ACLR is most prevalent in adolescents and young adults (Granan et al, 2008;Granan et al, 2009;Janssen et al, 2012;Joseph et al, 2013;Lind et al, 2009) persistent knee difficulties could impede on work responsibilities, sporting desires and parenting roles with great potential to impact upon QOL and psychological health.…”

“…Anterior cruciate ligament rupture most commonly occurs in adolescents and young adults during competitive sport participation (Granan et al, 2009;Janssen et al, 2012;Renstrom et al, 2008). Estimates of ACLR prevalence reveal an alarmingly high rate of ACLR in Australia, exceeding other countries with a rate of 52 per 100,000 inhabitants (Csintalan, 2008;Gianotti et al, 2009;Granan et al, 2008;Granan et al, 2009;Janssen et al, 2012;Lind et al, 2009).…”

“…Anterior cruciate ligament reconstruction is a common procedure in sports medicine, with estimated surgical rates of 52 per 100,000 inhabitants in Australia (Janssen et al, 2012), 30 per 100,000 in the United States (Csintalan, 2008) and 32 per 100,000 in Sweden (Granan et al, 2009). The overall aim of ACLR is to restore knee biomechanics, allow resumption of pre-injury activities, and optimise QOL.…”