Patient injury claims for posterior cruciate ligament injury: a nationwide registry study in Finland

Abstract

Background and purpose: Posterior cruciate ligament (PCL) injuries usually occur in combination with other ligamentous knee injuries. The outcome varies and may be poor due to suboptimal treatment. We investigated claims following PCL injury treatment on a nationwide scale.

Patients and methods: All patient PCL injury claims filed in Finland from 1997 to 2015 were collected from the Patient Insurance Centre (PIC) register. We reviewed and analyzed all records to determine the causes of claims. General background data were obtained from the National Care Register for Social Welfare and Health Care (HILMO).

Results: We found out from HILMO background data that, during the 19-year study period, 1,891 PCL and 1,380 multiligament reconstructions were performed in 99 different hospitals. The number of PCL injuries treated conservatively is unknown. During this same period, 49 claims arrived at the PIC, and 39/49 of these patients were operated on. 12/49 claims were compensated. Of these 12 claims, 6 were compensated for technical errors and 4 were compensated for diagnostic delays.

Conclusion: The number of patient injury claims was few, and compensated claims were even fewer. Technical errors and diagnostic delays were the most common reasons for reimbursement.

Figure 1

Posterior cruciate ligament and multiligament injury-related procedures in Finland from 1997 to 2015 from the Care Register for Social Welfare and Health Care (HILMO). For Abbreviations, see Table 2.

Figure 2

Number of posterior cruciate ligament reconstructions (PCLR = NGE40 + NGE45) and multiligament reconstructions (MLR = NGE50 + NGE 55) in different hospital groups. In high-volume hospitals left panel), the peak years of PCLR are between 2003 and 2006, and of MLR are between 2008 and 2011. In medium-volume hospitals (middle panel), the peak years of PCLR are between 2007 and 2011, and of MLR are between 2009 and 2011. In low-volume hospitals (right panel), the peak years of PCLR are between 2009 and 2014, and the number of MLR has started to rise since 2013. For Abbreviations, see Table 2.

Figure 3

All patient injury claims and compensated claims from the Patient Injury Centre (PIC) from 1997 to 2015, divided into 4 categories according to the contents of the claims and the decisions of the PIC. DSSI = deep surgical site infection. ML = multiligament. MLR = ML reconstruction. PCL = posterior cruciate ligament. PCLR = PCL reconstruction. High = high-volume hospital. Medium = medium-volume hospital. Low = low-volume hospital.

Figure 4

Annual number of posterior cruciate ligament reconstructions (PCLR) and multiligament reconstructions (MLR) (left panel) and annual number of claims submitted to the PIC (right panel) from 1997 to 2015.