Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3464-3470
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3464
Demographic characteristics of patients who underwent anterior cruciate ligament reconstruction at a tertiary care hospital in India
Sai Krishna Mlv, Asjad Mahmood, Pulak Vatsya, Siva Srivastava Garika, Ravi Mittal, Manoj Nagar
Sai Krishna Mlv, Asjad Mahmood, Pulak Vatsya, Siva Srivastava Garika, Ravi Mittal, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
Manoj Nagar, Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal 462020, India
Author contributions: Mlv SK and Mehmood A wrote the manuscript; Vatsya P and Garika SS collected the data; Nagar M and Mittal R planned this study; Mittal R corrected the manuscript.
Institutional review board statement: This study was approved by the Institute Ethics Committee, All India Institute of Medical Sciences, New Delhi, India through letter, No. IECPG-584/28.10.2021, RT-16/25.11.2021.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The study was conducted after ethic clearance from All India Institute of Medical Sciences, New Delhi. All the data was recovered from medical records and telephone interviews. The identity of the patients was not revealed anywhere in the study. No additional data is available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ravi Mittal, FRCS, MBBS, MS, Professor, Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.ravimittal66@hotmail.com
Received: January 16, 2023
Peer-review started: January 16, 2023
First decision: January 31, 2023
Revised: February 16, 2023
Accepted: April 17, 2023
Article in press: April 17, 2023
Published online: May 26, 2023
Abstract
BACKGROUND

Anterior cruciate ligament (ACL) tears are common sports-related injuries. Their incidence is not the same either for all the sports or for the same sport across various nations. This information is maintained by many sports leagues in their registries. However, very few nationwide registries exist for such injuries. This study is carried out to know the demographic characteristics of patients who underwent ACL reconstruction at our hospital in India.

AIM

To know the demographic characteristics of patients who underwent ACL reconstruction at a tertiary care hospital in India.

METHODS

All the patients who underwent ACL reconstruction from January 2020 to December 2021 were retrospectively studied. Patients with multi-ligament injuries or a history of previous knee surgery were excluded. The patients’ history was obtained from the hospital records, they were interviewed telephonically, and online questionnaires were given. Their demographic data was analyzed and compared to the existing literature.

RESULTS

A total of 124 patients were operated on for ACL reconstruction during this period. The mean age of the patients was 27.97 years. One hundred and thirteen patients (91.1%) were male and 11 (8.9%) were female. The majority of the patients (47.6%) sustained this injury by road traffic accidents (RTA) followed by sports-related injuries (39.5%). The commonest presenting complaint was giving way of the knee in 118 patients (95.2%). The mean duration from the injury to the first hospital visit among the patients was 290.1 d. The mean duration from the injury to surgery was 421.8 d.

CONCLUSION

ACL patients’ demography is different in developing nations as compared to the developed world. RTA are the leading cause of ACL injuries and are followed by recreational sports as a cause. There is delayed access to healthcare leading to delayed diagnosis as well as even greater time to surgery. This, in turn, leads to poorer prognosis and longer rehabilitation. National registries for developing nations are the need of the hour due to the different demographics of ACL injuries in developing countries.

Keywords: Anterior cruciate ligament, Sports injury, Demography, Epidemiology, Knee

Core Tip: This epidemiological study sheds light on multiple novel data points about anterior cruciate ligament (ACL) injuries in low and middle-income countries (LMICs). First, road traffic accidents are the commonest cause for an ACL injury in LMICs, making it an injury of the common man rather than being related to sports. Second, the patients have delayed presentation, prolonged symptoms, delayed reconstruction of these lesions, and a higher number of days spent with disability. Third, the majority of the patients in our cohort, belong to the low or middle-income groups. This creates another constraint for patients to get access to a healthcare facility where their injury can be diagnosed and operated upon. Fourth, we often get patients with ACL injuries with very unusual modes of injury like accidents with animals on roads. Such things are unheard of in developed regions. Fifth, contrary to the popular belief, a non-sport person would require the same level of care and treatment as a sports person, because his livelihood depends on physical labor and hard work. We suggest that any orthopedic surgeon, actively involved in treating ACL and other knee injuries in LMICs, should be aware of such trends and treat and counsel the patients accordingly.