{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:28:15Z","timestamp":1788845295822,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cruciate ligament reconstruction (ACLR) performed by high-volume surgeons\/clinics has been associated with increased graft individualization and decreased operating times, complication rates, and total costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate the influence of surgeon\/clinic volume on subjective knee function and revision surgery rates at 2 years after primary ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Data from the Swedish National Knee Ligament Registry were used to study patients who underwent primary ACLR between 2008 and 2019. Surgeons\/clinics were categorized based on a combination of total caseload volume (cutoff: 50 ACLRs\/surgeon, 500 ACLRs\/clinic) and annual volume (cutoff: 29 ACLRs\/year\/surgeon, 56 ACLRs\/year\/clinic). The thresholds of minimal important change (MIC), Patient Acceptable Symptom State (PASS), and treatment failure (TF) relative to the Knee injury and Osteoarthritis Outcome Score (KOOS) and KOOS\n                      <jats:sub>4<\/jats:sub>\n                      (mean score of the KOOS Pain, Symptoms, Sports\/Rec, and QoL subscales) were applied. Adjusted multivariable logistic regression was performed to assess variables influencing the MIC, PASS, or TF of the KOOS and KOOS\n                      <jats:sub>4<\/jats:sub>\n                      . Adjusted Cox regression analysis was conducted to determine the hazard ratio of subsequent ACLR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 35,371 patients, 16,317 had 2-year follow-up outcome data and were included. Patients who underwent primary ACLR by high-volume surgeons had significantly higher MIC and PASS rates and lower TF rates when compared with patients who underwent the procedure by low-volume surgeons: MIC\n                      <jats:sub>KOOS4<\/jats:sub>\n                      : 70.6% vs 66.3%; PASS\n                      <jats:sub>KOOS4<\/jats:sub>\n                      : 46.0% versus 38.3%; and TF\n                      <jats:sub>KOOS4<\/jats:sub>\n                      : 8.7% versus 11.8% (all P &lt; .02). Significantly decreased odds of achieving MIC\n                      <jats:sub>KOOS4<\/jats:sub>\n                      (OR, 0.74; 95% CI, 0.62-0.88) and PASS\n                      <jats:sub>KOOS4<\/jats:sub>\n                      (OR, 0.71; 95% CI, 0.60-0.84) were found for ACLRs performed by low-volume surgeons. Clinic volume did not influence the odds of reaching MIC, PASS, or TF. Overall, 804 patients (2.3%) underwent subsequent ACLR at &lt;2 years, with significantly higher revision rates among patients operated on at high-volume clinics (2.5% vs 1.7%; P &lt; .001). However, in the adjusted Cox regression, surgeon\/clinic volume had no influence on subsequent ACLR rates. High-volume surgeons\/clinics had decreased time to surgery, operating time, perioperative complication rates, and use of thromboprophylaxis and nonroutine antibiotics ( P &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients who underwent primary ACLR by high-volume surgeons experienced increased improvement and satisfaction regarding subjective knee function. Factors other than surgical volume influenced subsequent surgery rates. Patients might benefit from undergoing primary ACLR by high-volume providers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671241233695","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T06:28:51Z","timestamp":1710138531000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Influence of Surgeon Experience and Clinic Volume on Subjective Knee Function and Revision Rates in Primary ACL Reconstruction: A Study from the Swedish National Knee Ligament Registry"],"prefix":"10.1177","volume":"12","author":[{"given":"Dzan","family":"Rizvanovic","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Orthopaedics, V\u00e4xj\u00f6 Central Hospital, Region Kronoberg, V\u00e4xj\u00f6, 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