Increased incidence of anterior cruciate ligament revision surgery in paediatric verses adult population
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To evaluate the anterior cruciate ligament graft failure rate in a population of 1376 patients submitted to single-bundle anterior cruciate ligament reconstruction procedure. It was hypothesized that the younger the patient, the greater the chance of a new anterior cruciate ligament graft ligament injury.
A retrospective chart review was performed on patients who had SB anterior cruciate ligament reconstruction between the years, 2001 and 2016, with a minimum post-operative follow-up period of 6 months. The patient population was divided into three groups, according to age: group 1—under 16 years old; group 2—between 16 and 18 years old; and group 3—older than 18 years old. Data collected included sex, laterality and graft choice data.
In group 1 (under 16 years old), there were 61 primary ACL surgeries performed and 15 (24.6%) revision ACL surgeries. In group 2 (between 16 and 18 years old), there was 57 primary ACL procedures, of which 10 (17.5%) were revisions. In the group 3 (older than 18 years of age), 1258 surgeries were done with 116 (9.2%) revisions.
The rate of ACL revision surgery in patients under 16 years of age was significantly higher than that found in patients older than 18 years old. When compared to the population between 16 and 18 years old, there were a higher number of failure cases, however, statistically non-significant.
Level of evidence
KeywordsACL reconstruction Graft failure Knee Open physis Paediatric population
Anterior cruciate ligament
Ethics and Research Committee
Compliance with ethical standards
Conflict of interest
All authors declare no conflict of interest.
There was no funding for this study.
The present study was performed and approved by Ethics and Research Committee (CEP) from Universidade Federal de São Paulo (São Paulo/Brazil) (1181/11).
- 2.Andernord D, Björnsson H, Petzold M, Eriksson BI, Forssblad M, Karlsson J, Samuelsson K (2014) Surgical predictors of early revision surgery after anterior cruciate ligament reconstruction: results from the Swedish national knee ligament register on 13,102 patients. Am J Sports Med 42(7):1574–1582CrossRefPubMedGoogle Scholar
- 8.Davis DL, Almardawi R, Mitchell JW (2016) Analysis of the tibial epiphysis in the skeletally immature knee using magnetic resonance imaging: an update of anatomic parameters pertinent to physeal-sparing anterior cruciate ligament reconstruction. Orthop J Sports Med 4(6):2325967116655313PubMedPubMedCentralGoogle Scholar
- 13.Gifstad T, Foss OA, Engebretsen L, Lind M, Forssblad M, Albrektsen G, Drogset JO (2014) Lower risk of revision with patellar tendon autografts compared with hamstring autografts: a registry study based on 45,998 primary ACL reconstructions in Scandinavia. Am J Sports Med 42(10):2319–2328CrossRefPubMedGoogle Scholar
- 16.Krutsch W, Zellner J, Baumann F, Pfeifer C, Nerlich M, Angele P (2017) Timing of anterior cruciate ligament reconstruction within the first year after trauma and its influence on treatment of cartilage and meniscus pathology. Knee Surg Sports Traumatol Arthrosc 25(2):418–425CrossRefPubMedGoogle Scholar
- 24.Schlumberger M, Schuster P, Schulz M, Immendörfer M, Mayer P, Bartholomä J, Richter J (2015) Traumatic graft rupture after primary and revision anterior cruciate ligament reconstruction: retrospective analysis of incidence and risk factors in 2915 cases. Knee Surg Sports Traumatol Arthrosc 25(5):1535–1541CrossRefPubMedGoogle Scholar
- 25.Stracciolini A, Stein CJ, Zurakowski D, Meehan WP 3rd, Myer GD, Micheli LJ (2015) Anterior cruciate ligament injuries in pediatric athletes presenting to sports medicine clinic: a comparison of males and females through growth and development. Sports Health 7(2):130–136CrossRefPubMedPubMedCentralGoogle Scholar