An Interrupted Time Series Analysis Measuring the Impact of Research and Education on Clinical Practice

Maletis, Gregory B.; Prentice, Heather A.; Wyatt, Ronald; Paxton, Elizabeth W.; Funahashi, Tadashi T.

doi:10.2106/jbjs.22.00955

Journal of Bone and Joint Surgery

2023

DOI: 10.2106/jbjs.22.00955

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An Interrupted Time Series Analysis Measuring the Impact of Research and Education on Clinical Practice

Gregory B. Maletis

Heather A. Prentice

Ronald Wyatt

et al.

Abstract: Background: We sought to evaluate whether allograft utilization for primary anterior cruciate ligament reconstruction (ACLR) within our health-care system changed following the implementation of an allograft reduction intervention and whether revision rates within the health-care system changed following the initiation of the intervention. Methods:We conducted an interrupted time series study using data from Kaiser Permanente's ACL Reconstruction Registry.

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2024

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Cited by 4 publications

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Validating the capture rate of revisions by the New Zealand ACL Registry: An analysis of all‐cause reoperation following primary ACL reconstruction

Rahardja,

Love,

Clatworthy

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo validate the New Zealand Anterior Cruciate Ligament (ACL) Registry's capture rate of revisions by cross‐referencing Registry data with reoperations data recorded by the Accident Compensation Corporation (ACC) and identify risk factors for all‐cause reoperation.MethodsPrimary ACL reconstructions performed between April 2014 and September 2019 were individually matched on a record‐by‐record basis between the two databases. The ACC database was used to identify patients who underwent a reoperation with manual review of operation notes to identify whether a revision or other procedure was performed. This was combined with the number of revisions separately recorded in the New Zealand ACL Registry, which was used as the denominator value to calculate the Registry's capture rate of revisions. Patient and surgical data recorded in the Registry were analysed to identify independent predictors for all‐cause reoperation.ResultsA total of 8046 primary ACL reconstructions were matched between the New Zealand ACL Registry and the ACC databases. The reoperation rate was 8.9% (n = 715) at a mean follow‐up of 2.5 years. Meniscal‐related procedures were the most common reoperation (n = 299, 3.7%), followed by revision ACL reconstruction (n = 219, 2.7%), arthrofibrosis (n = 185, 2.3%), cartilage (n = 56, 0.7%) and implants (n = 32, 0.4%). The New Zealand ACL Registry captured 96% of revisions. Younger age (hazard ratio [HR] > 1.4, p < 0.001), earlier surgery (HR > 1.3, p = 0.05), concurrent meniscal repair (medial meniscus HR = 1.9, p < 0.001 and lateral meniscus HR = 1.3, p = 0.022) and hamstring tendon autografts (HR = 1.4, p = 0.001) were associated with a higher risk of reoperation.ConclusionThe New Zealand ACL Registry captured 96% of revisions. Risk factors for all‐cause reoperation included younger age, earlier surgery, meniscal repair and hamstring tendon autografts.Level of EvidenceLevel III.

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Validating the capture rate of revisions by the New Zealand ACL Registry: An analysis of all‐cause reoperation following primary ACL reconstruction

Rahardja,

Love,

Clatworthy

et al. 2024

Knee surg. sports traumatol. arthrosc.

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show abstract

Analysis of Changing Practice Trends in Anterior Cruciate Ligament Reconstruction: A Multicenter, Single-Institution Database Analysis

Klein,

Bartlett,

Huyke-Hernandez

et al. 2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Editorial Commentary: Analysis of Practice Patterns and Changes for Anterior Cruciate Ligament Surgery Document the Past and Present, but High-Quality Data Should Inform the Future

Maletis

2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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An Interrupted Time Series Analysis Measuring the Impact of Research and Education on Clinical Practice

Cited by 4 publications

References 28 publications

Validating the capture rate of revisions by the New Zealand ACL Registry: An analysis of all‐cause reoperation following primary ACL reconstruction

Validating the capture rate of revisions by the New Zealand ACL Registry: An analysis of all‐cause reoperation following primary ACL reconstruction

Analysis of Changing Practice Trends in Anterior Cruciate Ligament Reconstruction: A Multicenter, Single-Institution Database Analysis

Editorial Commentary: Analysis of Practice Patterns and Changes for Anterior Cruciate Ligament Surgery Document the Past and Present, but High-Quality Data Should Inform the Future

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