Return to Sport and Reoperation Rates in Patients Under the Age of 20 After Primary Anterior Cruciate Ligament Reconstruction: Risk Profile Comparing 3 Patient Groups Predicated Upon Skeletal Age
| Autor: | Sheena R Black, Frank A. Cordasco, Michael Heller, Joseph T. Nguyen, Daniel W. Green, Lori Ann Asaro, Colleen M. Wixted, Meghan Price |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Anterior cruciate ligament reconstruction Adolescent medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Hamstring Muscles Risk profile Risk Assessment Transplantation Autologous Return to sport 03 medical and health sciences Young Adult 0302 clinical medicine Age Determination by Skeleton medicine Humans Orthopedics and Sports Medicine In patient Prospective Studies Child 030222 orthopedics biology Anterior Cruciate Ligament Reconstruction business.industry Athletes Anterior Cruciate Ligament Injuries Age Factors Bone age 030229 sport sciences biology.organism_classification Surgery Return to Sport Pediatric sports medicine Knee ligament Athletic Injuries Female business Epiphyses Follow-Up Studies |
| Zdroj: | The American journal of sports medicine. 47(3) |
| ISSN: | 1552-3365 |
| Popis: | Background: With sports specialization and level of competition on the rise, anterior cruciate ligament reconstruction (ACLR) in athletes under the age of 20 has increased significantly in recent years. Reports have demonstrated that the revision ACLR rate is higher and return to sport (RTS) rate is lower in this population. Purpose: To evaluate the 2-year clinical outcomes of 3 cohorts of primary ACLR in pediatric and adolescent athletes under the age of 20 based on skeletal age with a focus on RTS and the incidence of second surgery. Study Design: Case series; Level of evidence, 4. Methods: This is a prospective evaluation of 324 athletes younger than 20 years of age who underwent ACLR with minimum 2-year follow-up. The surgical technique was selected predicated on skeletal age, which includes the all-epiphyseal technique with hamstring autograft in the youngest cohort in elementary and middle school (group 1), the partial transphyseal and complete transphyseal with hamstring autograft performed for athletes in the middle cohort (group 2), and bone-tendon-bone autograft in the skeletally mature high school athletes (group 3). Results: The mean chronological age of the entire cohort was 15 years (range, 8-19 years) with 55% males. The 3 cohorts included 49 patients (15%) in group 1 (mean age, 12 years), 66 (20%) in group 2 (mean age, 14.3 years), and 209 (65%) in group 3 (mean age, 16.2 years). Group 2 athletes had a significantly higher revision ACLR rate (20%) compared with group 1 (6%; P = .039) and group 3 (6%; P = .001). Similarly, group 2 athletes had significantly lower RTS rates (85%) compared with group 1 (100%) and group 3 (94%). Conclusion: The rate of revision ACLR was significantly higher and the RTS rates significantly lower in group 2 compared with groups 1 and 3. This age-related risk profile may be used to counsel athletes and parents preoperatively regarding the expectations of surgery with respect to revision ACLR and RTS rates. |
| Databáze: | OpenAIRE |
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