Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 10;10(2):223.
doi: 10.3390/jcm10020223.

Epidemiology of Anterior Cruciate Ligament Reconstruction Surgery in Italy: A 15-Year Nationwide Registry Study

Umile Giuseppe Longo  1 , Kanto Nagai  2 , Giuseppe Salvatore  1 , Eleonora Cella  3 , Vincenzo Candela  1 , Francesca Cappelli  1 , Massimo Ciccozzi  3 , Vincenzo Denaro  1
Affiliations

Epidemiology of Anterior Cruciate Ligament Reconstruction Surgery in Italy: A 15-Year Nationwide Registry Study

Umile Giuseppe Longo et al. J Clin Med. .

Abstract

There remains little information on the epidemiology of anterior cruciate ligament reconstruction (ACL-R), therefore, we performed an epidemiological evaluation on the ACL-R procedures performed in Italy from 2001 to 2015 to highlight potential disparities in access to healthcare. The National Hospital Discharge records (SDO) maintained at the Italian Ministry of Health were analyzed from 2001 to 2015; 248,234 ACL-Rs were performed in Italy over the 15-year study period in the adult population (starting from 15 years old), and the incidence rate per year in 100,000 persons ranged from 21.70 to 33.60 over the study period. The overall male/female ratio was 4.54. The length of hospitalization ranged from four days in 2001 to two days in 2015. Italy is historically divided into north, center, and south regions, and more than half of ACL-R surgery was performed in the north (67.2%); 95.2% of ACL-Rs were underwent in public institutions. The predicted model projected a slight growth in the number of ACL-Rs in the next 10 years (2016-2025). The number of ACL-R procedures increased in the adult population from 2001 to 2015. The ACL-R procedures were concentrated in the north of Italy, suggesting that efforts on regionalization of ACL-Rs should turn toward improving quality in hospitals in the south of Italy.

Keywords: anterior cruciate ligament; epidemiology; prevalence; reconstruction; registry; surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Percentage of ACL-Rs in Italian macro-regions.
Figure 2
Figure 2
(A) Number of surgeries per year—the entire population; (B) incidence of surgeries performed per 100,000 inhabitants.
Figure 3
Figure 3
(A) Number of ACL-Rs in Italy during the study period classified by gender; (B) age classes involved in ACL-Rs.
Figure 4
Figure 4
ACL-R surgery involvement regions.
Figure 5
Figure 5
ACL-R surgery trend based on regional residence.
Figure 6
Figure 6
Projection analysis of ACL-Rs.
Figure 7
Figure 7
Projection analysis of ACL-Rs by gender.
Figure 8
Figure 8
Projection analysis of ACL-Rs by age group.
See this image and copyright information in PMC

References

    1. Bollen S.R., Scott B.W. Rupture of the anterior cruciate ligament—A quiet epidemic? Injury. 1996;27:407–409. doi: 10.1016/0020-1383(96)00033-2. - DOI - PubMed
    1. Maffulli N., Longo U.G., Denaro V. Anterior cruciate ligament tear. N. Engl. J. Med. 2009;360:1463. doi: 10.1056/NEJMc082471. author reply 1463. - DOI - PubMed
    1. Lyman S., Koulouvaris P., Sherman S., Do H., Mandl L.A., Marx R.G. Epidemiology of anterior cruciate ligament reconstruction: Trends, readmissions, and subsequent knee surgery. J. Bone Jt. Surg. Am. Vol. 2009;91:2321–2328. doi: 10.2106/JBJS.H.00539. - DOI - PubMed
    1. Longo U.G., King J.B., Denaro V., Maffulli N. Double-bundle arthroscopic reconstruction of the anterior cruciate ligament: Does the evidence add up? J. Bone Jt. Surg. Br. 2008;90:995–999. doi: 10.1302/0301-620X.90B8.20083. - DOI - PubMed
    1. Gianotti S.M., Marshall S.W., Hume P.A., Bunt L. Incidence of anterior cruciate ligament injury and other knee ligament injuries: A national population-based study. J. Sci. Med. Sport. 2009;12:622–627. doi: 10.1016/j.jsams.2008.07.005. - DOI - PubMed

LinkOut - more resources