Gregory B. Maletis, M.D., chief of orthopaedics at the Kaiser Baldwin Park Medical Facility in California and clinical professor of orthopaedic surgery in the Keck/USC School of Medicine, has won the 2018 Orthopaedic Research and Education Foundation (OREF) Clinical Research Award.
This honor has been bestowed for his research titled “Optimizing Anterior Cruciate Ligament Reconstruction: Individualizing the Decision Making Process Using Data from the Kaiser Permanente ACLR [anterior cruciate ligament reconstruction] Registry.”
According to the American Academy of Orthopaedic Surgeons, “The researchers found that patients who were less than 21 years old had a 7.76 times higher risk of revision than those over 40 years old, and that graft type, gender, BMI [body mass index] and race were associated with the risk of revision in this age group. Additionally, graft type played a significant role in the risk of revision surgery, with allografts having a higher risk of revision in age groups 40 years old and younger.”
Dr. Maletis told OTW, “There are many factors that affect the outcomes of ACL reconstruction, but few factors are under the surgeons control.”
“One factor that the surgeon does have control of is the graft used for reconstruction. Not all grafts perform equally well for all patients. Determining which graft is most appropriate for a specific patient can be challenging. By using the patient’s age, BMI, and the sport they participate in, the risk calculator that we have developed can help patients and surgeons predict the probability of graft survival based on which graft is used for reconstruction. We hope that this helps to individualize care for patients undergoing ACLR surgery.”
“We believe that choosing the most appropriate graft for a specific patient will ultimately improve patient care. Our group, as well as others, have shown that younger patients are at the greatest risk for revision after ACLR surgery.”
“By choosing an autograft rather than an allograft, the risk of revision can be decreased. We hope that the clinical impact of our research will be that graft choice makes a difference in the overall risk of revision and that we have helped provide tools for surgeons and patients to make an informed choice.”
“Furthermore, we have demonstrated that practice change can occur in a large institution. Within our organization we have seen a nearly 70% decrease in allograft usage in patients 21 years of age and younger. Our experience shows that by informing surgeons with data regarding good and poor performing grafts and providing them with their own personal outcome data, patient care can be improved.”
Congratulations on a very well deserve award for a very knowledgeable, talented and very efficient ortho doctor and surgeon. He did a very successful surgery on my son’s torn ACL 15 years ago.
Dr. Maletis had successfully performed right ACL knee surgery on me in January 2003 using the hamstring graft at the age of 26 following a basketball-related injury. Currently, I’m scheduled for left knee surgery on May 2018 on my left knee at the age of 41 following another basketball injury. The data was helpful in providing me with all the information regarding graft choices The data showed that an allograft was suitable for less active and older patients. However, even if my activity level has reduced, I still think that the autograft (hamstring tendon / graft) was the best procedure given all the information especially in my personal experience, including the strength, stability and overall performance I’ve experienced over the last 15 years from my right knee procedure. Dr. Maletis is a phenomenal orthopedic surgeon and I’m confident my left knee (with committed rehabilitation) will be just as successful.