Globalepolicy.org is a free to access global medical news service for the consumer, professional and researcher.


             
 

Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

Background: No prospective surveillance system exists for monitoring the outcome of cruciate ligament surgery.

Purpose: This article is intended to describe the development and procedures of the Norwegian National Knee Ligament Registry (NKLR), including baseline results from the first 2 years of operation.

Study Design: Cohort study (prevalence); Level of evidence, 1.

Methods: The NKLR was established on June 7, 2004 to collect information prospectively on all cases of cruciate ligament reconstruction surgery in Norway. Information on the details of surgery is gathered through a registration form completed by the surgeon postoperatively, and a validated knee outcome score form is completed by the patients preoperatively and at follow-ups on all patients at 2, 5, and 10 years postoperatively. Hospital compliance was examined in 2005 and 2006.

Results: A total of 2793 primary cruciate ligament reconstruction surgeries were registered by 57 hospitals. This corresponds to an annual population incidence of primary anterior cruciate ligament reconstruction surgeries of 34 per 100 000 citizens (85 per 100 000 citizens in the main at-risk age group of 16–39 years). After 21 months of operation, the NKLR had an overall compliance of 97% when compared with the hospital records.

Conclusions: A national population-based cruciate ligament registry has been developed, implemented, and maintained in Norway. The registry will each year enroll approximately 1500 primary cruciate ligament reconstruction cases. It is expected that inadequate procedures and devices can be identified, as well as prognostic factors associated with good and poor outcomes, at least for the most frequent categories.




August 2008
Mon Tue Wed Thu Fri Sat Sun
« Jul    
 123
45678910
11121314151617
18192021222324
25262728293031