Pattern of Anterior Cruciate Ligament Reconstruction (ACLR) among Athletes in Malaysia between 2015 and 2020

Abstract

Background. Individual involvement in sports activity is rising and thus increases the risk of knee injury. Anterior Cruciate Ligament (ACL) rupture is the most common knee injury requiring ACL reconstruction (ACLR). However, limited evidence is available to date on ACLR characteristics in Malaysia for comparison with Western countries. This study aims to describe the epidemiological characteristic of ACLR surgery and the trend of pre-operative physiotherapy (pre-habilitation).
 Materials and methods. ACLR cases recorded in a tertiary hospital database between January 2015 and December 2020 were extracted and reviewed. This retrospective study was approved by the hospital’s Research Ethics Committee (UKMPPI/111/8/JEP-2020-500). All ACLR cases involving sports injuries were included with the exclusion of non-sports related injuries. Yearly ACLR cases were retrieved using an Injury Information form containing variables namely age, gender, type of ACL tear, accompanying meniscus injury, duration from injury to surgery and pre-habilitation details. Descriptive statistics were used to summarize the sample data.
 Results. A total of 131 ACLR cases were reported between 2015 and2020 (Male, n =122; Female, n = 25). The number of ACLR cases fluctuated during the observed years, with a maximum of 30 cases reported in a year and 98% of the cases were represented by the youth age group (15 – 47 years old). The average age at time of surgery was 27.1 (± 7.79). On an average, 80% of athletes stated no history of previous knee injury. The most common type of ACL injury was a complete tear (88%), followed by partial tear (9%), and re-rupture (3%). A meniscus injury was noted in 61% of cases. The time from injury to surgery was 15 weeks. The study found low percentage of the ACLR patients who received pre-habilitation prior to surgery (<20%).
 Conclusions. ACLR cases are showing a fluctuating trend every year. Despite the majority of the ACL cases being a complete tear, the participants waited more than four months to undergo ACLR, with only a quarter of them had pre-habilitation prior to surgery. The reasons for these situations require investigation. Future research inclusive of a larger database is also desirable to develop a better insight into ACL injury pattern.