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Low-Volume and Early-Career Surgeons Have Higher Risk for Reoperation and Complications Following Anterior Cruciate Ligament Reconstruction

  • 0University of California, San Francisco, School of Medicine, San Francisco, California, U.S.A.
Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association +

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October 30, 2024

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October 30, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Surgeons with lower yearly anterior cruciate ligament reconstruction (ACLR) case volumes and early-career surgeons face higher risks of revision ACLR and postoperative complications. Higher surgeon volume is linked to better outcomes.

Area Of Science

  • Orthopedic Surgery
  • Sports Medicine
  • Health Services Research

Background

  • Anterior cruciate ligament reconstruction (ACLR) is a common orthopedic procedure.
  • Understanding surgeon characteristics influencing ACLR outcomes is crucial for patient safety and quality improvement.

Purpose Of The Study

  • To characterize US surgeons performing ACLRs.
  • To investigate the impact of surgeon volume, career duration, and practice setting on ACLR outcomes.

Main Methods

  • Retrospective cohort study using a large nationwide insurance database (2015-2019).
  • Analysis of 54,498 primary ACLRs performed by 3,782 surgeons.
  • Examined surgeon factors (volume, career duration, practice setting) and outcomes (reoperations, hospitalizations, ED visits), controlling for patient variables.

Main Results

  • Low yearly ACLR volume surgeons had higher revision rates and ED visits.
  • High yearly ACLR volume surgeons had lower revision rates.
  • Early career surgeons showed increased reoperations and ED visits.
  • Academic affiliation was linked to more non-ACLR reoperations, ED visits, and hospital readmissions.

Conclusions

  • Patients treated by early career or low-volume surgeons face elevated risks for revision ACLR and postoperative emergency department visits.
  • Surgeon experience and practice volume are significant factors in ACLR success.