Anterior cruciate ligament reconstruction-related patient injuries: a nationwide registry study in Finland

Authors

  • Kirsi-Maaria Nyrhinen Department of Orthopaedics and Traumatology, Helsinki University Central Hospital
  • Ville Bister Department of Surgery, Hyvinkää Hospital, Hyvinkää
  • Teemu Helkamaa Department of Orthopaedics and Traumatology, Helsinki University Central Hospital
  • Arne Schlenzka Department of Orthopaedics and Traumatology, Helsinki University Central Hospital
  • Henrik Sandelin Orthopaedic Department, Liverpool Hospital, Sidney, New South Wales, Australia
  • Jerker Sandelin ORTON Orthopaedic Hospital, Invalid Foundation, Helsinki, Finland
  • Arsi Harilainen ORTON Orthopaedic Hospital, Invalid Foundation, Helsinki, Finland

DOI:

https://doi.org/10.1080/17453674.2019.1678233

Abstract

Background and purpose — Treatment outcomes of anterior cruciate ligament (ACL) injuries are generally good, but complications after ACL reconstruction (ACLR) can result in long-lasting problems. Patient injury claims usually fall on the more severe end of the complication spectrum. They are important to investigate because they may reveal the root causes of adverse events, which are often similar regardless of the complication’s severity. Therefore, we analyzed ACL-related patient injuries in Finland, the reasons for these claims, causes of complications, and grounds for compensation.

Patients and methods — We analyzed all claims filed at the Patient Insurance Centre (PIC) between 2005 and 2013 in which the suspected patient injury occurred between 2005 and 2010. This study also reviewed all original patient records and available imaging studies. General background data were obtained from the National Care Register for Social Welfare and Health Care (HILMO).

Results — There were 248 patient injury claims, and 100 of these were compensated. Compensated claims were divided into 4 main categories: skill-based errors (n = 46), infections (n = 34), knowledge-based errors (n = 6), and others (n = 14). Of the compensated skill-based errors, 34 involved graft malposition, 26 of them involved the femoralside tunnel. All compensated infections were deep surgical site infections (DSSI).

Interpretation — This is the first nationwide study of patient injuries concerning ACLRs in Finland. The most common reasons for compensation were DSSI and malposition of the drill tunnel. Therefore, it would be possible to decrease the number of serious complications by concentrating on infection prevention and optimal surgical technique.

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Published

2019-10-15

How to Cite

Nyrhinen, K.-M., Bister, V., Helkamaa, T., Schlenzka, A., Sandelin, H., Sandelin, J., & Harilainen, A. (2019). Anterior cruciate ligament reconstruction-related patient injuries: a nationwide registry study in Finland. Acta Orthopaedica, 90(6), 596–601. https://doi.org/10.1080/17453674.2019.1678233