Evidence map›Paper›PMID 29404653›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Surgeon experience with dynamic intraligamentary stabilization does not influence risk of failure.

Philipp Henle, Kathrin S Bieri, Janosch Haeberli, Nele Arnout, Jan Victor, Mirco Herbort, Clemens Koesters, Stefan Eggli

Erratum issuedAbstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Dynamic intraligamentary stabilization for ACL repair: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019
    Pooled it
  3. Trial
  4. Improved results of ACL primary repair in one-part tears with intact synovial coverage.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Philipp HenleDepartment of Knee Surgery and Sports Traumatology, Sonnenhof Orthopaedic Center, Bern, Switzerland.
Kathrin S BieriSwiss RDL, Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland. kathrin.bieri@ispm.unibe.ch.
Janosch HaeberliDepartment of Knee Surgery and Sports Traumatology, Sonnenhof Orthopaedic Center, Bern, Switzerland.
Nele ArnoutGhent University Hospital, Ghent, Belgium.
Jan VictorGhent University Hospital, Ghent, Belgium.
Mirco HerbortUniversity Hospital Muenster, Westphalian-Wilhelms University, Muenster, Germany.
Clemens KoestersUniversity Hospital Muenster, Westphalian-Wilhelms University, Muenster, Germany.
Stefan EggliDepartment of Knee Surgery and Sports Traumatology, Sonnenhof Orthopaedic Center, Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeStudies on dynamic intraligamentary stabilization (DIS) of acute anterior cruciate ligament (ACL) ruptures reported failure rates similar to those of conventional ACL reconstruction. This study aimed to determine whether surgeon experience with DIS is associated with revision rates or patient-reported outcomes. The hypothesis was that more experienced surgeons achieved better outcomes following DIS due to substantial learning curve.

methodsThe authors prospectively enrolled 110 consecutive patients that underwent DIS and evaluated them at a minimum of 2 years. The effects of independent variables (surgeon experience, gender, age, adjuvant procedures, tear location, preinjury Tegner score, time from injury to surgery, and follow-up) on four principal outcomes (revision ACL surgery, any re-operation, IKDC and Lysholm score) were analyzed using univariable and multivariable regressions.

resultsFrom the 110 patients enrolled, 14 patients (13%) were lost to follow-up. Of the remaining 96 patients, 11 underwent revision ACL surgery, leaving 85 patients for clinical assessment at a mean of 2.2 ± 0.4 years (range 2.0-3.8). Arthroscopic reoperations were performed in 26 (27%) patients, including 11 (11%) revision ACL surgeries. Multivariable regressions revealed: (1) no associations between the reoperation rate and the independent variables, (2) better IKDC scores for 'designer surgeons' (b = 10.7; CI 4.9-16.5; p < 0.001), higher preinjury Tegner scores (b = 2.5, CI 0.8-4.2; p = 0.005), and younger patients (b = 0.3, CI 0.0-0.6; p = 0.039), and (3) better Lysholm scores for 'designer surgeons' (b = 7.8, CI 2.8-12.8; p = 0.005) and preinjury Tegner score (b = 1.9, CI 0.5-3.4; p = 0.010).

conclusionSurgeon experience with DIS was not associated with rates of revision ACL surgery or general re-operations. Future, larger-scaled studies are needed to confirm these findings. Patients operated by 'designer surgeons' had slightly better IKDC and Lysholm scores, which could be due to better patient selection and/or positively biased attitudes of both surgeons and patients. LEVEL OF EVIDENCE: Level II, prospective comparative study.

Indexed as

Clinical CompetenceSurgeonsAdultAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionFemaleFollow-Up StudiesHumansMalePatient Outcome AssessmentProspective StudiesReoperationAnterior cruciate ligamentDynamic intraligamentary stabilizationLigamysOutcomesRevision surgerySurgeon experience

Identifiers

PMID29404653

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.