The Relationship between Surgical Centre Volume and Outcome Following Anterior Cruciate Ligament Reconstruction

Description

The presentation led by Kyle Martin discusses the findings from a study on the Norwegian knee ligament registry, the world's first national knee ligament register established in 2004, which documents around 1,800 ACL reconstructions annually. The study aimed to compare outcomes of ACL reconstruction between high-volume and low-volume hospitals to clarify implications of the current surgical care model. In total, over 19,000 patients' data was analyzed, revealing that only 6% of the patients were treated at low-volume hospitals (less than one procedure per month), while 46% were treated at hospitals performing more than 50 procedures yearly. The study found that patients at low-volume hospitals tended to be older, heavier, and less active, with surgical operations taking more than 50% longer and reporting complications twice as frequently compared to high-volume hospitals. However, paradoxically, the revision rates after surgery were significantly lower at these low-volume hospitals. The study concludes that restricting ACL reconstruction to high-volume hospitals may not be necessary based on revision rates alone, although higher complication rates and longer surgery durations must be considered, especially for patients in rural areas who may face challenges accessing high-volume centers. The presenter highlights the importance of balancing geographic access to care with the quality of surgical outcomes.

DOI: 10.1302/3114-210409

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