The rate of anterior cruciate ligament reconstruction in Australia is high: a national registry is needed

Supporting a registry is an investment in the long term health of our nation

This issue of the MJA includes the results of an important study that again indicate the high rate of anterior cruciate ligament (ACL) reconstruction in Australia.1 It was already known that Australia has relatively high rates of knee ACL injuries, surgical reconstruction,2,3 and knee replacement (arthroplasty).4 The new data highlight worrying increases in the rates of both primary and revision ACL reconstruction, particularly in adolescents.1 Many factors could potentially explain an increase in the rate of ACL surgery, including more accurate diagnosis, greater access to surgery, and more people playing sport (factors that would be pleasing), but also an increase in the rate of ACL injuries per exposure (which would be disappointing). It is harder to envisage a positive explanation for an increase in the revision ACL reconstruction rate, but it is important to differentiate between contributors to failure, particularly between surgical factors (ie, techniques associated with a higher failure rate) and rehabilitation factors, such as returning to sport before adequate functional recovery has been achieved.5,6