Modern trends in primary anterior cruciate ligament reconstruction: data from the local registry of the Vreden National Medical Research Center of Traumatology and Orthopedics for 2023-2024

Background. Medical registries play an important role in modern evidence-based medicine, providing objective data on the comparative effectiveness of various treatment methods and their long-term outcomes. Since 2023, Vreden National Medical Research Center of Traumatology and Orthopedics has maintained a local registry of knee cruciate ligament reconstruction maintained, the performance of which requires a detailed study. The aim of the study — to analyze main trends in primary anterior cruciate ligament reconstruction using data from the local registry of the Vreden National Medical Research Center of Traumatology and Orthopedics, and to compare the obtained results with those from foreign registries. Methods. The study included data on 850 patients from the knee cruciate ligament registry who underwent primary anterior cruciate ligament (ACL) reconstruction. To compare the obtained results with global data, official reports and articles containing information on the work of leading foreign ACL reconstruction registries — Denmark, Sweden, Norway, the United Kingdom, the United States (Kaiser Permanente), and New Zealand — were reviewed. Results. The mean patient age was 35±9 years [23.6; 35.1], with a pronounced predominance of males within the cohort (71.7%). Regarding the distribution of graft types, a slight preference for autografts was observed (52.9%). Among the allografts utilized, the tibialis posterior tendon was overwhelmingly preferred, accounting for 81.6% of all allografts. Concomitant meniscal injuries were diagnosed in 69.2% of cases. Concerning surgical technique, the transtibial approach was the most frequently employed, utilized in 34.6% of cases. The data on the surgical technique were missing from the registry for 16.8% of cases. An 8 mm graft diameter was the most commonly used size for drilling both the femoral (45.0%) and tibial (46.4%) tunnels. For both the transtibial and anteromedial techniques, the primary method of fixation was a “button — screw” combination, employed in 64.0% and 60.9% of cases, respectively. Conclusion. The present study has demonstrated the potentially high informational value of the local registry as a tool for analyzing various aspects of primary anterior cruciate ligament reconstruction. However, a direct comparison with foreign data appears challenging due to the substantial difference in the sample size between our data and those of the large foreign anterior cruciate ligament reconstruction registries.