DOS Kongressen 2014 ·
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Do ACL patients suffer from comorbidity and is there
any association between comorbidity and the risk of
ACL revision surgery? A nationwide population-based
case-cohort study of 13,443 ACL reconstructed patients
Lene Rahr-Wagner, Theis Thillemann, Martin Lind, Alma Pedersen
Department of Orthopaedic surgery, Aalborg University Hospital; Department
of Clinical Epidemiology, Aarhus University Hospital
Background:
Anterior cruciate ligament (ACL) reconstructed patients are con-
sidered healthy individuals. However, information on comorbid disease is lack-
ing.
Purpose / Aim of Study:
The aim of this study was to describe and compare
comorbid conditions among ACL reconstructed patients and a matched cohort
without ACL injury. Further, to evaluate the impact of comorbid diseases on the
risk of ACL revision surgery.
Materials and Methods:
This case-cohort study included 13,443 unilat-
eral primary ACL reconstructed patients from the Danish Knee Ligament
Reconstruction Register (DKRR) matched on gender and age with a compari-
son cohort without ACL injury. Information on medical comorbid conditions
was obtained from the Danish National Registry of Patient. The prevalence of
all comorbid conditions was described for ACL reconstructed patients and the
comparison cohort in terms of: 1) Charlson Comorbidity Index (CCI) 2) ICD-10
disease chapters, 3) more common chronic diseases in a younger population.
Finally we assessed the risk of ACL revision surgery according to the comorbid
conditions, using Cox regression analysis.
Findings / Results:
ACL reconstructed patients had generally a slightly lower
prevalence of almost all ICD-10 classified comorbid disease groups compared to
the comparison cohort without ACL injury. The percentage of CCI=0 was high in
both groups. As expected most diseases increased slightly with rising age. Most
of the comorbid conditions did not affect the risk of revision surgery.
Conclusions:
This study provides new information on comorbid conditions
in ACL reconstructed patients, which has not previously been described. This
study supports the hypothesis that ACL patients are generally healthy individu-
als. A large variety of diseases are present in the ACL reconstructed group, but
with very low prevalence and a low CCI indicating a healthy cohort.
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