In a population-based epidemiological study published in the July 6, 2016 Journal of Bone & Joint Surgery, Tibor et al. found that from 2007 to 2014:
- Many ACL-reconstruction surgeons changed from a transtibial approach to either an anteromedial portal or lateral approach for femoral-tunnel drilling.
- Most did not substantially change the types of grafts they used.
- Many eschewed first-generation bioabsorbable implants in favor of biocomposite fixation devices.
The authors found no change in cumulative revision rates during the study period.
Tibor et al. analyzed information from 21,686 primary ACL reconstructions housed in a Kaiser Permanente registry that collected data from surgeries performed in 33 hospitals by 246 surgeons in urban, rural, and suburban settings in three Western US states. This wide-ranging data set, the authors say, “increases the generalizability of our findings to other community-based surgeons.”
The authors admit, however, that the epidemiological nature of the study “offers only limited insight into associated outcomes,” and they were unable to analyze cost trends because the registry does not capture cost data.