Objectives We investigated the temporal trend and the geographical variation in the rate of an anterior cruciate ligament (ACL) reconstruction and meniscal repair (MR) performed in England during a 20-year window. Methods All hospital episodes for patients undergoing ACL reconstruction or MR between 1 April 1997 and 31 March 2017 were extracted by procedure code from the national hospital episode statistics. Age-standardised and sex-standardised rates of surgery were calculated using Office for National Statistics population data as the denominator and analysed over time both nationally and regionally by National Health Service clinical commissioning group (CCG). Results Between 1997–1998 and 2016–2017, there were 133 270 cases of ACL reconstruction (124 489 patients) and 42 651 cases of MR (41 120 patients) (isolated or simultaneous). Nationally, the rate of ACL reconstruction increased 12-fold from 2.0/100K population (95% CI 1.9 to 2.1) in 1997–1998 to 24.2/100K (95% CI 23.8 to 24.6) in 2016–2017. The rate of MR increased more than twofold from 3.0/100K (95% CI 2.8 to 3.1) in 1997–1998 to 7.3/100K (95% CI 7.1 to 7.5) in 2016–2017. Of these cases, the rate of simultaneous ACL reconstruction and MR was 2.6/100K (95% CI 2.5 to 2.8) in 2016/2017. In 2016–2017, for patients aged 20–29, the sex-standardised rate of ACL reconstruction was 76.9/100K (95% CI 74.9 to 78.9) and for MR was 19.8/100K (95% CI 18.8 to 20.9). Practice varied by region—in 2016–2017, 14.5% (30/207) of the CCGs performed more than twice the national average rate of ACL reconstruction and 15.0% (31/207) performed more than twice the national average rate of MR. Conclusions The rate of ACL reconstruction (12-fold) and MR (2.4-fold) has increased in England over the last two decades. There is variation in these rates across geographical regions and further work is required to deliver standardised treatment guidance for appropriate use.

中文翻译：

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过去 20 年英格兰的前交叉韧带 (ACL) 重建和半月板修复率均有所增加：1997 年至 2017 年的医院统计数据

目标 我们调查了英格兰在 20 年的时间窗内进行的前交叉韧带 (ACL) 重建和半月板修复 (MR) 率的时间趋势和地理变化。方法 1997年4月1日至2017年3月31日期间接受ACL重建或MR患者的所有住院事件按程序代码从全国医院事件统计数据中提取。使用国家统计局人口数据作为分母计算年龄标准化和性别标准化的手术率，并由国家卫生服务临床委员会（CCG）在全国和地区范围内随时间进行分析。结果 1997-1998年和2016-2017年间ACL重建133 270例（124 489例），MR 42 651例（41 120例）（孤立或同时）。在全国范围内，ACL 重建率从 1997-1998 年的 2.0/100K（95% CI 1.9 至 2.1）增加到 2016-2017 年的 24.2/100K（95% CI 23.8 至 24.6），增加了 12 倍。MR 的发生率从 1997-1998 年的 3.0/100K（95% CI 2.8 至 3.1）增加到 2016-2017 年的 7.3/100K（95% CI 7.1 至 7.5）。在这些病例中，2016/2017 年同时 ACL 重建和 MR 的比率为 2.6/100K（95% CI 2.5 至 2.8）。2016-2017 年，20-29 岁患者的 ACL 重建性别标准化率为 76.9/100K（95% CI 74.9 至 78.9），MR 为 19.8/100K（95% CI 18.8 至 20.9）。实践因地区而异——2016-2017 年，14.5% (30/207) 的 CCG 的 ACL 重建率是全国平均率的两倍以上，15.0% (31/207) 的 MR 率是全国平均率的两倍以上。结论 ACL 重建率（12 倍）和 MR（2. 4 倍）在过去的二十年中在英格兰增加了。不同地理区域的这些比率存在差异，需要进一步工作以提供适当使用的标准化治疗指南。