489 Management of ACL Injuries and the Impact of the Coronavirus Pandemic: A Regional Audit

Aim 15,000 anterior cruciate ligament (ACL) reconstructions are performed annually in the United Kingdom. The aim of this audit was to compare local management of ACL injury at the University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) to current British Orthopaedic Association Standards for Trauma (BOAST) guidelines. A secondary aim was to understand the effect of the COVID-19 pandemic on the management of ACL reconstruction. Method The audit was registered with the local audit department. Lists of patients with ACL reconstructions were obtained across two time periods and data was extracted from the electronic patient record software and PACS. The pre-covid period, was defined between 1st of July 2018 and the 1st of July 2019. The post-covid period was defined between 1st of July 2021 and 1st of July 2022. Microsoft Excel software was used for analysis. Results Sixty cases were identified, with a mean age of 28. 37 patients were from the pre-covid period, and 23 patients from the post-covid period. 82% of patients underwent a timely clinic assessment following initial presentation, in accordance with guidelines. 37% of cases had an MRI scan completed within 14 days. 38% of cases were referred for prehabilitation. The average time to surgery was 230.5 days in the pre-covid period, increasing to 353.9 days in the post-covid period. 84% of patients had post-operative physiotherapy. Conclusions The results demonstrate poor compliance with current guidance. The COVID-19 pandemic had a significant impact on average time to surgery. An improved multidisciplinary approach is required to improve functional outcomes.