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Transitioning between medical equipment suppliers does not affect ACL reconstruction outcomes in a high-volume
Dzan Rizvanovic1,2, Anders Stålman1,2, Christoffer von Essen1,2
1Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden.
Purpose:
To investigate whether changing medical equipment suppliers in anterior cruciate ligament reconstruction (ACLR) influences surgical time, revision rates and subjective outcomes.
Methods:
A retrospective cohort study was conducted using data from the Swedish Knee Ligament Registry (SKLR). On 1 September 2016, Capio Artro Clinic, Stockholm, Sweden, changed its supplier for all medical equipment, from Smith & Nephew (SN) to Arthrex (AR). Patients who underwent primary ACLR during the preceding year (from 1 September 2015) formed group SN and were compared with patients operated between 1 September 2016 and 1 September 2017, divided into three consecutive 4-month cohorts (AR1-3) for temporal comparison. Primary outcome was surgical time. Secondary outcomes were revision rates at 2 and 5 years, and the aggregate Knee injury and Osteoarthritis Outcome Score (KOOS4) at 2 years using thresholds for minimal important change (MIC), Patient Acceptable Symptom State (PASS), treatment failure (TF) and perioperative complications.
Results:
A total of 1175 patients underwent a primary ACLR during the study period. Group SN included 521 patients, and Groups AR1-3, 654. Of the 521 patients in Group SN, 488 (93.7%) had surgical time recorded, with a median of 61 (interquartile range [IQR]: 50-73) min. In Groups AR1-3, 560 patients (85.6%) had surgical time recorded, with median times of 63 (IQR: 52-78), 60 (IQR: 50-70) and 60 (IQR: 50-70) min, respectively, showing no significant differences. Of the included patients, 573 (48.8%) completed KOOS at the 2-year follow-up, with no significant differences between groups regarding MIC, PASS or TF. Within 2 years, 31 patients (2.6%) underwent revision ACLR, and after 5 years, an additional 21 patients, totalling 52 (4.4%), with no significant group differences.
Conclusion:
Experienced ACL surgeons can transition between suppliers with acceptable outcomes, comparable surgical times and low complication rates.
Level Of Evidence:
Level III.
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