title: Feasibility of establishing an Australian ACL registry: a pilot study by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).
abstract: OBJECTIVE
  Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible.
  
  
  METHODS
  Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data.
  
  
  RESULTS
  A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study.
  
  
  CONCLUSIONS
  It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent would not be an issue in for a national registry where inclusion is automatic unless the patient wishes to opt out. The collection of post-operative patient-reported outcome measures (PROMs) is more problematic, due to an insufficient proportion of individuals providing patient-reported outcomes. Alternative outcome measures are required for an ACL registry in Australia to be successfully implemented.
  
  
  METHODS
  Diagnostic, Level III.
authors.affiliation: Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, SA, 5001, Australia.
authors.forename: Christina
authors.initials: C
authors.lastname: Lekkas
authors.affiliation: Wakefield Orthopaedic Clinic, Adelaide, SA, 5000, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Clarnette
authors.affiliation: Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, SA, 5001, Australia.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Graves
authors.affiliation: Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, SA, 5001, Australia. srainbird@aoanjrr.org.au.
authors.forename: Sophia
authors.initials: S
authors.lastname: Rainbird
authors.affiliation: Northshore Private Hospital, St Leonards, NSW, 2065, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Parker
authors.affiliation: South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, 5001, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lorimer
authors.affiliation: Sportsmed SA, Stepney, SA, 5069, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Paterson
authors.affiliation: Mater Hospital, Wollstonecraft, NSW, 2065, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Roe
authors.affiliation: St Vincent's Private East Melbourne (Mercy), Fitzroy, VIC, 3065, Australia.
authors.forename: Hayden
authors.initials: H
authors.lastname: Morris
authors.affiliation: Epworth HealthCare, Richmond, VIC, 3121, Australia.
authors.forename: Julian A
authors.initials: JA
authors.lastname: Feller
authors.affiliation: Bethesda Hospital, Claremont, WA, 6010, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Annear
authors.affiliation: The Wesley Hospital, Auchenflower, QLD, 4066, Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Forster
authors.affiliation: Brisbane Private Hospital, Brisbane, QLD, 4000, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Hayes
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000453:epidemiology* / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012042:Registries; D011795:Surveys and Questionnaires
keywords: ACL; Anterior cruciate ligament; Clinical assessment/grading scales; General sports trauma; Knee ligaments; Knee reconstruction