Symbolic image representing ACL patient registry compliance challenges.

ACL Registry: Predicting Follow-Up Compliance and Why It Matters

Jordan Keane in Health & Wellness July 2025 • 3 min read.

"Discover the surprising factors influencing patient participation in ACL registries and how this impacts research and treatment outcomes."

Anterior cruciate ligament (ACL) injuries are among the most common orthopedic issues, frequently requiring ACL reconstruction (ACLR). Given their high incidence and significant impact on patients, ACL injuries and their management remain a focal point in orthopedic research. However, while many studies concentrate on surgical techniques and outcomes, few address the methods of research themselves, particularly how to minimize variability and enhance validity in reported results.

Pathology-driven registries play a crucial role in monitoring clinical practice and providing valuable data for medical research. These registries, however, are susceptible to various forms of bias, including patient noncompliance in completing registry forms. This issue is particularly relevant in registries heavily reliant on patient-reported outcomes (PROs). Addressing and predicting noncompliance is essential to improving the efficacy and value of registry-based data.

A recent study aimed to pinpoint patient-specific factors influencing compliance with ACLR registry forms at 6, 12, and 24 months postoperatively. The researchers hypothesized that no specific patient factors would correlate with compliance at any of the investigated time points, setting the stage for potentially surprising revelations.

What Factors Influence ACL Registry Compliance?

Symbolic image representing ACL patient registry compliance challenges.

Researchers at a major medical center retrospectively reviewed data from patients prospectively enrolled in the ACLR registry since March 2015. The study included patients followed for at least six months, excluding those who didn't complete initial registry forms. Participants filled out forms preoperatively and at 6, 12, and 24 months postoperatively. The study looked at several factors:

Statistical analysis was performed to assess the impacts of:

Age
Race
Employment Status
Medical Insurance
Smoking Status
Driving Distance to the Hospital
Importance of Returning to the Same Level of Sporting Activity

Multivariate analysis examined variables at 6 and 12 months, while univariate analysis was used for the 24-month follow-up due to smaller numbers. The goal was to identify any significant correlations between these factors and patient compliance.

The Road Ahead: Improving Registry Compliance

By understanding the factors that contribute to non-compliance, future studies can be designed to better engage at-risk patients, ensuring more complete and reliable data. This, in turn, leads to more robust research and improved patient outcomes in ACL reconstruction and related orthopedic procedures.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s00590-018-2327-3, Alternate LINK

Title: Risk Factors Associated With Acl Registry Compliance: Can We Predict Who Will Follow-Up?

Subject: Orthopedics and Sports Medicine

Journal: European Journal of Orthopaedic Surgery & Traumatology

Publisher: Springer Science and Business Media LLC

Authors: Yehia H. Bedeir, Kimberly A. Hasselfeld, Henry A. Kuechly, Christopher J. Utz, Barton R. Branam, Angelo J. Colosimo, Brian M. Grawe

Published: 2018-10-25

Everything You Need To Know

What are ACLR registries, and why are they important?

ACL reconstruction (ACLR) registries are databases that collect patient information following ACLR procedures. They are vital for monitoring clinical practices and providing data for medical research. Their significance lies in their ability to offer insights into treatment outcomes, surgical techniques, and patient recovery, helping to improve the quality of care and the effectiveness of interventions for ACL injuries. The implications of these registries are far-reaching, potentially influencing surgical protocols, rehabilitation strategies, and long-term patient management.

Why are patient-reported outcomes (PROs) so important in ACLR registries?

Patient-reported outcomes (PROs) are crucial because they capture the patient's perspective on their recovery, function, and quality of life after ACLR. These outcomes offer a comprehensive view of the impact of the procedure and related treatments, encompassing aspects like pain levels, functional limitations, and overall satisfaction. The implications of relying on PROs mean that the data's reliability depends on patients' adherence to completing the registry forms. Non-compliance can skew results and diminish the validity of research findings.

What specific factors were investigated to determine their influence on ACL registry compliance?

Factors such as age, race, employment status, medical insurance, smoking status, driving distance to the hospital, and the importance of returning to sporting activities were examined. The implications of understanding these factors mean that healthcare providers can proactively address barriers to participation and tailor interventions to improve registry compliance. Identifying risk factors allows researchers to develop targeted strategies to engage patients and enhance the accuracy of registry data.

What does 'compliance' mean in the context of ACLR registries, and why is it important?

Compliance in ACLR registries is the extent to which patients complete the required forms at the designated follow-up time points (6, 12, and 24 months postoperatively). High compliance ensures a complete and representative dataset, leading to more reliable research findings and a better understanding of treatment outcomes. Non-compliance introduces bias and reduces the validity of research results. Addressing non-compliance improves the quality of registry data, leading to more informed clinical decisions and better patient care.

How can researchers improve compliance with ACLR registries?

Improving registry compliance involves identifying and addressing factors that contribute to non-completion of registry forms. Understanding these factors helps researchers design more effective engagement strategies, such as targeted patient education, reminders, and support. By understanding the factors that influence compliance, future studies can be designed to better engage at-risk patients, ensuring more complete and reliable data. This, in turn, leads to more robust research and improved patient outcomes in ACL reconstruction and related orthopedic procedures. These actions ultimately contribute to more accurate research and, in turn, better patient care and outcomes.