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Capstone

Postoperative anterior cruciate ligament reconstruction outcomes: Phase II

15 August 2006

Abstract

Background: The goal of this study is to provide outcomes data for ACL reconstruction surgeries to a single physician/surgeon and the patient. Outcomes data collected and analyzed for a single physician will provide the surgeon with information that can be given to patients seeking ACL reconstruction surgery. This information will help the patient know what to expect in terms of recovery, infection rate, and failure rate. It will also aid the surgeon in identifying areas of strength and weakness in his practice. To accomplish this goal a database was created using Filemaker Pro 7 software that allows for data entry at the point of care and basic data analysis. The analyzed data will be given to ACL reconstruction surgery candidates likely in the form of a handout or pamphlet during the informed consent process.

Hypothesis: Collection of subjective and objective data should allow for a better understanding of the post-operative outcomes of a single surgeon for ACL reconstruction surgery and improve the understanding patients have in regards to expectations for their surgery. The use of the database will allow for increased efficiency and ease in data analysis.

Methods: 41 patients were included in this case series study at the Orthopedic and Fracture Clinic in Portland, Oregon. Test subjects were invited by a single orthopedic surgeon to participate if they had an ACL injury requiring reconstructive surgery. Subjective data was collected including demographics, previous knee surgery/injury, satisfaction, and a knee functioning/activity questionnaire (IKDC form). Objective data collected was done using the KT-1000 arthrometer and physical exam. Data was collected during office visits at preoperative, 3 month, 6 month, 12 month, and 24 month appointments.

Results: The ACL outcomes database appears to be a useful tool for data collection, storage, and analysis for a solo orthopedic physician practice. Preliminary data shows that the single orthopedic physician providing the surgical services in this study has comparable outcomes when compared to his peers in the areas of infection rate, graft rupture rate, and patient satisfaction. To date, there have been 0 infections, 0 graft ruptures, and good to excellent patient satisfaction in approximately 90% of cases. The small sample size, high rate of loss to follow up, and ongoing status of this study prohibit the author from making further conclusions at this time.

Conclusions: The ACL outcomes database should prove useful for data collection, storage and analysis. The single orthopod in this study currently shows comparable outcomes data to his peers in the areas examined.


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