| Abstract ID |
| 20260009 |
| Category |
| Knee: ACL |
| Preferable Presentation |
| Oral Presentation |
| Title |
| EPIDEMIOLOGY OF FIRST ANTERIOR CRUCIATE LIGAMENT TEAR AND PRIMARY RECONSTRUCTION IN HONG KONG PUBLIC HOSPITALS, 1993-2024: A POPULATION-BASED STUDY |
| Author |
|
| Presenter |
| Kenney Ki Lee Lau |
| Abstract |
| Background Anterior cruciate ligament (ACL) tear constitutes a disabling knee injury. However, long-term epidemiological data at the population level, utilizing standardized measures outside Western contexts, remain scarce. Electronic medical records from public hospitals can be employed to quantify incidence rates and the adoption of surgical interventions, thereby informing prevention strategies and healthcare service planning. Objectives This study aimed to quantify the three-decade burden of first ACL tears and primary ACL reconstructions in Hong Kong, reporting the overall, age-standardized, and sex-standardized incidence rates, as well as reconstruction proportions. Additionally, it sought to examine age-specific and sex-specific differences in ACL tear incidence and reconstruction rates. Study Design & Methods This retrospective cohort study used data from the Clinical Data Analysis and Reporting System developed by the Hospital Authority in Hong Kong, covering records from 47 public hospitals between 1993 and 2024. ACL tears were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes 717.83 and 844.2, while ACL reconstructions were identified via ICD-9-CM procedure codes 81.43 and 81.45. In cases of multiple records, only the initial episodes were considered. The annual crude incidence rate per 100,000 population was calculated using Hong Kong population data as the denominator. The reconstruction proportion was calculated as the number of reconstructions divided by the number of tears. Age- standardized and sex-standardized rates were obtained by weighting to the standard population structure. Differences across age groups and between sexes were assessed using one-way analysis of variance with Bonferroni-adjusted post-hoc comparisons. Results A total of 18,386 individuals experienced a first ACL tear, with 77% subsequently undergoing ACL reconstruction. The mean annual incidence of ACL tears was 8 per 100,000 persons and remained unchanged after adjusting for age and sex. The average annual proportion of reconstructions was 66%, with age-standardized and sex-standardized proportions of 42% and 63%, respectively. Incidence of ACL tears peaked among individuals aged 20–29 years, and this age group also had the highest proportion undergoing reconstruction. Males had a higher incidence of ACL tears than females, whereas the proportion undergoing reconstruction did not differ significantly by sex. Conclusions Over a 32-year period of public hospital data, ACL tears in Hong Kong predominantly affected young adults, especially men in their twenties, with the majority of identified tears progressing to surgical reconstruction. The application of age- and sex-standardization, along with the use of an at-risk denominator (tears), considerably modified apparent treatment rates, thereby enhancing comparability across regions and over time to support prevention strategies and surgical capacity planning. Acknowledgement This study was supported by the InnoHK initiative of the Innovation and Technology Commission of the Hong Kong Special Administrative Region Government. |