Age, Sex, and BMI Differences Related to Repairable Meniscal Tears in Pediatric and Adolescent Patients.

Autor:	Rohde MS; Stanford University School of Medicine, Department of Orthopaedics, Stanford, California, USA., Shea KG; Stanford University School of Medicine, Department of Orthopaedics, Stanford, California, USA., Dawson T 2nd; Stanford University School of Medicine, Department of Orthopaedics, Stanford, California, USA., Heyworth BE; Boston Children's Hospital, Department of Orthopaedic Surgery, Boston, Massachusetts, USA., Milewski MD; Boston Children's Hospital, Department of Orthopaedic Surgery, Boston, Massachusetts, USA., Edmonds EW; Rady Children's Hospital, Division of Orthopaedic Surgery, San Diego, California, USA., Adsit E; Scottish Rite for Children, Dallas, Texas, USA., Wilson PL; Scottish Rite for Children, Dallas, Texas, USA; University of Texas Southwestern Medical Center, Department of Orthopaedics, Dallas, Texas, USA., Albright J; Children's Hospital Colorado, Department of Orthopedics, Aurora, Colorado, USA., Algan S; Oklahoma Children's Hospital, Department of Orthopedic Surgery, Oklahoma City, Oklahoma, USA., Beck J; Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA; Orthopedic Institute for Children's Center for Sports Medicine, Los Angeles, California, USA., Bowen R; Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA; Orthopedic Institute for Children's Center for Sports Medicine, Los Angeles, California, USA., Brey J; Norton Children's Orthopedics of Louisville, Department of Orthopedics, Louisville, Kentucky, USA., Cardelia M; Children's Hospital of the King's Daughters, Department of Orthopedics and Sports Medicine, Norfolk, Virginia, USA., Clark C; OrthoCarolina Pediatric Orthopaedic Center, Charlotte, North Carolina, USA., Crepeau A; Elite Sports Medicine at Connecticut Children's, Hartford, Connecticut, USA; UConn Health, Division of Sports Medicine, Department of Orthopedics, Farmington, Connecticut, USA., Edmonds EW; Rady Children's Hospital, Division of Orthopaedic Surgery, San Diego, California, USA., Ellington M; Central Texas Pediatric Orthopedics, Department of Orthopedics, Austin, Texas, USA; Dell Medical School, University of Texas at Austin, Austin, Texas, USA., Ellis HB; Scottish Rite for Children, Dallas, Texas, USA; University of Texas Southwestern Medical Center, Department of Orthopaedics, Dallas, Texas, USA., Fabricant P; Hospital for Special Surgery, Division of Pediatric Orthopaedic Surgery, New York, New York, USA; Weill Cornell Medical College, New York, New York, USA., Frank J; Joe DiMaggio Children's Hospital, Division of Pediatric Orthopaedics and Spinal Deformities, Hollywood, Florida, USA., Ganley T; Children's Hospital of Philadelphia, Sports Medicine and Performance Center, Philadelphia, Pennsylvania, USA., Green D; Hospital for Special Surgery, Division of Pediatric Orthopaedic Surgery, New York, New York, USA., Gupta A; Joe DiMaggio Children's Hospital, Division of Pediatric Orthopaedics and Spinal Deformities, Hollywood, Florida, USA., Heyworth BE; Boston Children's Hospital, Department of Orthopaedic Surgery, Boston, Massachusetts, USA., Latz K; Children's Mercy, Department of Orthopedics-Sports Medicine, Kansas City, Missouri, USA., Mansour A; UTHealth Houston, McGovern Medical School, Department of Orthopedic Surgery, Houston, Texas, USA., Mayer S; Children's Hospital of Colorado, Department of Orthopaedic Surgery, Denver, Colorado, USA., McKay S; Texas Children's Hospital, Department of Orthopedic Surgery, Houston, Texas, USA., Milewski M; Boston Children's Hospital, Department of Orthopaedic Surgery, Boston, Massachusetts, USA., Niu E; Children's National Medical Center, Department of Orthopedic Surgery and Sports Medicine, Washington, DC, USA., Pacicca D; Children's Mercy, Department of Orthopedics-Sports Medicine, Kansas City, Missouri, USA., Parikh S; Cincinnati Children's Hospital Medical Center, Division of Orthopaedic Surgery, Cincinnati, Ohio, USA., Rhodes J; Children's Hospital Colorado, Department of Orthopedics, Aurora, Colorado, USA., Saper M; Seattle Children's Hospital, Department of Orthopedics and Sports Medicine, Seattle, Washington, USA., Schmale G; Seattle Children's Hospital, Department of Orthopedics and Sports Medicine, Seattle, Washington, USA., Schmitz M; San Antonio Military Medical Center, San Antonio, Texas, USA., Shea K; Stanford University School of Medicine, Department of Orthopaedics, Stanford, California, USA., Storer S; Joe DiMaggio Children's Hospital, Division of Pediatric Orthopaedics and Spinal Deformities, Hollywood, Florida, USA., Wilson PL; Scottish Rite for Children, Dallas, Texas, USA; University of Texas Southwestern Medical Center, Department of Orthopaedics, Dallas, Texas, USA., Ellis HB; Scottish Rite for Children, Dallas, Texas, USA; University of Texas Southwestern Medical Center, Department of Orthopaedics, Dallas, Texas, USA.; Investigation performed at Scottish Rite for Children, University of Texas Southwestern, Dallas, Texas, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2023 Feb; Vol. 51 (2), pp. 389-397. Date of Electronic Publication: 2023 Jan 11.
DOI:	10.1177/03635465221145939
Abstrakt:	Background: The incidence of meniscus tears and ACL tears in pediatric patients continues to rise, bringing to question the risk factors associated with these injuries. As meniscus tears are commonly repaired in pediatric populations, the epidemiology of repairable meniscus tears is an important for consideration for surgeons evaluating treatment options. Purpose: To describe meniscal tear patterns in pediatric and adolescent patients who underwent meniscal repair across multiple institutions and surgeons, as well as to evaluate the relationship between age, sex, and body mass index (BMI) and their effect on the prevalence, type, and displacement of repaired pediatric meniscal tears. Study Design: Case series; Level of evidence, 4. Methods: Data within a prospective multicenter cohort registry for quality improvement, Sport Cohort Outcome Registry (SCORE), were reviewed to describe repaired meniscal tear patterns. All consecutive arthroscopic meniscal repairs from participating surgeons in patients aged <19 years were analyzed. Tear pattern, location, and displacement were evaluated by patient age, sex, and BMI. A subanalysis was also performed to investigate whether meniscal tear patterns differed between those occurring in isolation or those occurring with a concomitant anterior cruciate ligament (ACL) injury. Analysis of variance was used to generate a multivariate analysis of specified variables. Sex, age, and BMI results were compared across the cohort. Results: There were 1185 total meniscal repairs evaluated in as many patients, which included 656 (55.4%) male and 529 (44.6%) female patients. Patients underwent surgery at a mean age of 15.3 years (range, 5-19 years), with a mean BMI of 24.9 (range, 12.3-46.42). Of the 1185 patients, 816 (68.9%) had ACL + meniscal repair and 369 (31.1%) had isolated meniscal repair. The male patients underwent more lateral tear repairs than the female patients (54.3% to 40.9%; P < .001) and had a lower incidence of medial tear repair (32.1% vs 41.4%; P < .001). Patients with repaired lateral tears had a mean age of 15.0 years, compared with a mean age of 15.4 years for patients with repaired medial or bilateral tears ( P = .001). Higher BMI was associated with "complex" and "radial" tear repairs of the lateral meniscus ( P < .001) but was variable with regard to medial tear repairs. Conclusion: In pediatric and adolescent populations, the data suggest that the surgical team treating knees with potential meniscal injury should be prepared to encounter more complex meniscal tears, commonly indicated in those with higher BMI, while higher rates of lateral meniscal tears were seen in male and younger patients. Future studies should analyze correlates for meniscal repair survival and outcomes in this pediatric cohort undergoing knee surgery.
Databáze:	MEDLINE
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