Anterior cruciate ligament reconstruction and concomitant procedures in Finland between 2004 and 2018 based on national registers.

BACKGROUND AND PURPOSE: We aimed to assess the incidence of anterior cruciate ligament reconstruction (ACLR) and concomitant procedures in Finland. PATIENTS AND METHODS: We identified all the patients who underwent ACLR between 2004 and 2018 in Finland using national registry data. Patients with an ICD-10 diagnosis code S83.5 and the NOMESCO operation codes NGE30 or NGE35 were included. We recorded the patient's age, sex, Charlson comorbidity index, and concomitant procedures. NGE30 or NGE35 was defined as the main procedure and all other procedures attached to this procedure were included as concomitant procedures. RESULTS: Our study included 37,224 ACLRs. The overall incidence of ACLR was 46 (95%CI 34-62) per 105 person-years. This increased from 38 per 105 person-years in 2004 to its peak of 53 in 2014 before decreasing to 47 by 2018. Male patients had a higher overall incidence of ACLR than female patients (61 [CI 47-78] vs. 32 [CI 22-45] per 105 person-years, respectively). However, this difference changed over time: for the males, a decrease in ACLR incidence was observed after 2014, whereas for the females, the trend increased throughout the study period. For both sexes, the highest incidence of ACLRs was in the age group 16-29 years (159 and 71 per 105 person-years, respectively). Concomitant procedures were performed at the time of ACLR in 32% of cases. CONCLUSION: While the total incidence of ACLR decreased slightly from 2014 to 2018, it increased among women over the full study period, which might be due to increased female participation in contact sports. Special attention should be given to girls' and women's ACL rupture prevention and treatment.

Return to work following anterior cruciate ligament reconstruction.

BACKGROUND AND PURPOSE: Amongst people of working age, the return to work (RTW) after anterior cruciate ligament (ACL) reconstruction is an important marker of success of surgery. We determined when patients are able to return to work after ACL reconstruction and identified factors that are associated with the timing of RTW. PATIENTS AND METHODS: We used logistic regression analyses to examine patient-related factors that may be associated with the length of RTW (above vs. below the median 59 days) after arthroscopic ACLR in a large cohort of patients working in the public sector in Finland (n = 803; n = 334 male, n = 469 female; mean age 41 years [SD 8.6]). RESULTS: The mean length of RTW was 65 days (SD 41). Higher odds ratios (OR) were observed for age groups 40-49 and ≥ 50 years compared with ≤ 30 years old (OR 2.0, 95% confidence interval 1.3-3.1 and 2.0, 1.2-3.4, respectively); for lower level non-manual and manual work compared with higher level non-manual work (3.0, 2.0-4.3 and 4.9, 3.4-7.0, respectively); and for those who had been on sick leave > 30 days in the preceding year (2.0, 1.4-2.9). Sex, comorbid conditions, preceding antidepressant treatment and concomitant procedures were not associated with the length of RTW. INTERPRETATION: Factors associated with prolonged sick leave beyond the median time of 59 days are higher age, lower occupational status, and preoperative sick leaves.