title: Complications following anterior cruciate ligament reconstruction in the English NHS.
abstract: Unlike the English National Joint Registry (NJR) for arthroplasty, no surgeon driven national database currently exists for ligament surgery in England. Therefore information on outcome and adverse events following anterior cruciate ligament (ACL) surgery is limited to case series. This restricts the ability to make formal recommendations upon surgical care. Prospectively collected data, which is routinely collected on every NHS patient admitted to hospital in England, was analysed to determine national rates of 90-day symptomatic deep venous thrombosis (DVT), pulmonary thromboembolism (PTE) rate, 30-day wound infection and readmission rates following primary ACL reconstruction between March 2008 and February 2010 (13,941 operations, annual incidence 13.5 per 100,000 English population). 90-day DVT and PTE rates were 0.30% (42) and 0.18% (25) respectively. There were no in-hospital deaths. 0.75% (104) of the consecutive patient cohort had a wound complication recorded. 0.25% (35) underwent a further procedure to wash out the infected knee joint and 1.36% (190) were readmitted to an orthopaedic ward within 30days. This is the first national comprehensive study of the incidence of significant complications following ACL surgery in England. This should allow meaningful interpretation of future baseline data supporting the development of a national ligament registry.
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, Woodhorn Lane, Ashington, Northumberland, NE63 9JJ, UK. simonjameson@doctors.org.uk
authors.forename: Simon S
authors.initials: SS
authors.lastname: Jameson
authors.forename: Daniel
authors.initials: D
authors.lastname: Dowen
authors.forename: Philip
authors.initials: P
authors.lastname: James
authors.forename: Ignacio
authors.initials: I
authors.lastname: Serrano-Pedraza
authors.forename: Mike R
authors.initials: MR
authors.lastname: Reed
authors.forename: David
authors.initials: D
authors.lastname: Deehan
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000009:adverse effects*; D002648:Child; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012042:Registries; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D006113:United Kingdom / Q000453:epidemiology; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult