2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

Ardern, Clare L; Ekås, Guri Ranum; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F.; Chotel, Franck; Cohen, Moisés; Forssblad, Magnus; Ganley, Theodore J.; Feller, Julian A.; Karlsson, Jón; Kocher, Mininder S.; LaPrade, Robert F.; McNamee, Mike; Mandelbaum, Bert R.; Micheli, Lyle J.; Mohtadi, Nicholas G.; Reider, Bruce; Roe, Justin; Seil, Romain; Siebold, Rainer; Silvers-Granelli, Holly; Soligard, Torbjørn; Witvrouw, Erik; Engebretsen, Lars

doi:10.1007/s00167-018-4865-y

Cited by 88 publications

(95 citation statements)

References 149 publications

(197 reference statements)

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“…41 Likewise, the KOOS-Child has demonstrated good psychometric properties in 7- to 16-year-old children with knee disorders. 69 In a consensus statement by Ardern et al, 2 the Pedi-IKDC and KOOS-Child were suggested as appropriate PROMs for children with ACL injury. In our review, only 5 studies used the Pedi-IKDC, and 1 study used the KOOS-Child.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the recent consensus statement highlights the need for standardized, pediatric-specific PROMs to be applied in future studies evaluating the treatment of children and adolescents after ACL injury. 2 To our knowledge, no studies so far have evaluated the long-term outcomes after pediatric ACL injury, including the risk of developing knee osteoarthritis. Thus, the need for reliable and valid outcome measures that can be applied in both childhood and adulthood seem warranted.…”

Section: Discussionmentioning

confidence: 99%

“…However, as long as no standardized core set of outcome measures exists to evaluate pediatric patients with ACL injury, it is difficult to compare results across studies. The consensus statement by Ardern et al 2 addressed this issue, and it is likely that their recommendations will influence future outcome reporting in pediatric ACL injury research in the direction of more uniformity.…”

Section: Discussionmentioning

confidence: 99%

“…82,96 Thus, pediatric ACL injuries have attracted substantial interest in clinical research, and the need for prospective research on outcomes after surgical and nonsurgical treatment has been highlighted. 2 However, to provide a scientific basis that can evaluate the consequences of pediatric ACL injuries, it is imperative to have relevant and valid outcome measures. A review of clinical research on adults with ACL injury found high variability in outcome reporting.…”

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confidence: 99%

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Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Zebis

Warming

Pedersen

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:The incidence of anterior cruciate ligament (ACL) injuries in children is increasing. However, no standardized core set of outcome measures exists for evaluating pediatric ACL injuries.Purpose:To perform a scoping review of the literature to identify patient-reported outcome measures (PROMs) and objective outcome measures used to evaluate pediatric patients after ACL injury and to classify these in accordance with the International Classification of Functioning, Disability, and Health (ICF) domains.Study Design:Systematic review; Level of evidence, 4.Methods:The literature was systematically searched with the PubMed, EMBASE, CINAHL, and PEDro databases. The inclusion criteria were Danish, Norwegian, Swedish, German, or English language; publication between 2010 and 2018; pediatric ACL injury (patients ≤15 years old); and outcome measures. The selected papers were screened for title, abstract, and full text in accordance with predefined inclusion and exclusion criteria.Results:A total of 68 papers (4286 patients; mean ± SD age, 12.2 ± 2.3 years) were included. Nineteen PROMs and 11 objective outcome measures were identified. The most frequently reported PROMs were the International Knee Documentation Committee (IKDC) Subjective Knee Form (51% of studies), Lysholm scoring scale (46% of studies) and Tegner activity rating scale (37% of studies). Additionally, return to sport was reported in 41% of studies. The most frequent objective measures were knee laxity (76% of studies), growth disturbances (69% of studies), range of motion (41% of studies), and muscle strength (21% of studies). With respect to the ICF domains, the IKDC covered all 3 ICF health domains, the Lysholm score covered the Body Structure and Function and the Activity Limitation domains, while the Tegner score covered the Participation Restriction domain. Objectively measured knee joint laxity, range of motion, and muscle strength covered 1 domain (Body Structure and Function).Conclusion:Pediatric patients with ACL injury were mainly evaluated subjectively with the IKDC and objectively by knee joint laxity. No consensus exists in the evaluation of children after ACL injury. The majority of applied outcome measures are developed for adults. To cover the ICF health domains, future research needs to consider reliable and valid outcome measures relevant for pediatric patients with ACL injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Zebis

Warming

Pedersen

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…Due to the special requirements of training and competitions, physical fitness is especially important for competitive alpine ski racers, regardless of their age [ 2 ]. Therefore, a comprehensive fitness program starting at a young age is crucial for alpine ski racers to cope with the physical demands of alpine ski racing and minimizing the rate of both traumatic and overuse injuries [ 3 , 4 , 5 ]. In Austria, ski boarding schools are a critical part of the long-term development of youth alpine ski racers.…”

Section: Introductionmentioning

confidence: 99%

Maximal Isometric or Eccentric Hamstring Strength—Which Test Modality Might Be More Suitable for Assessments in Youth Alpine Ski Racers?

Luchner

Steidl-Müller

Niedermeier

et al. 2021

IJERPH

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Background: Physical fitness is an important component in the development of youth alpine ski racers. To write systematically planned and age-appropriate fitness programs athletes need to be physically tested at regular intervals at an early age. Although well-developed hamstring muscle strength is important for alpine ski racing performance and the prevention of serious knee injuries, it has not been well investigated, especially in youth athletes. Accordingly, the first aim of the present study was to assess the test-retest reliability of the maximum bilateral eccentric (MBEHS) and unilateral isometric (MUIHS) hamstring tests. The second aim of the present study was to assess whether the results of these two methods correlate and if it is possible to commit to one of the two methods to provide an economic test procedure. Methods: The first study included 26 (14 females/12 males) youth alpine ski racers aged between 12 and 13 years. All athletes performed two MBEHS and two MUIHS tests, 7 days apart. The intraclass correlation coefficient (ICC 3,1) and their 95% confidence intervals based on a consistency two-way mixed model were used to estimate the reliability of the two different test modalities. The second study included 61 (27 females/34 males) youth alpine ski racers aged between 10 and 13 years. All athletes performed one MBEHS and one MUIHS test. Bland-Altman plots and the 95% limits of agreement as well as correlations by Pearson (r) between the different test modalities were assessed. Results: In study 1 “poor” to “moderate” (MBEHS right leg 0.79 (0.58–0.90); left leg 0.83 (0.66–0.92); MUIHS right leg 0.78 (0.56–0.89); left leg 0.66 (0.37–0.83)) ICC values and 95% confident intervals were obtained. Standard error of measurement (SEM) between trails was between 18.3 and 25.1 N. Smallest detectable difference (SDD) was between 50.8 and 69.5 N. In study 2 mean differences between MBEHS and MUIHS was around 20 N with higher values for MBEHS. Significant moderate-to-strong correlations were found between the test modalities (r = 0.74–0.84, p <0.001). Conclusions: The MBEHS test has higher ICC values, lower CV values, higher SEM values and lower SDD values than the MUIHS test. All this suggests that the MBEHS test is more suitable than the MUIHS test to determine the maximum hamstring force in young alpine ski racers.

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Anterolateral augmentation procedures during anterior cruciate ligament reconstructions in skeletally immature patients: Scoping review of surgical techniques and outcomes

Dietvorst,

Verhagen,

van der Steen

et al. 2024

J. exp. orthop.

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PurposeGraft failure rates after anterior cruciate ligament reconstruction (ACLR) in children and adolescents are higher compared to adults. Anterolateral augmentation procedures have recently generated increased focus regarding their ability to reduce graft failure rates. Concerns in skeletally immatures are potential growth disturbances and overconstraint after anterolateral augmentation. The aim of this scoping review is to provide an overview of all current anterolateral augmentation procedures in skeletally immature patients and to discuss surgical techniques, clinical and biomechanical outcomes.MethodsThis scoping review was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analysis) statement extension for scoping reviews. On 22 December 2022, an information specialist performed a systematic literature search in Cochrane, PubMed (Medline) and EMBASE databases. Inclusion criteria were anterolateral augmentation procedures, including lateral extra‐articular tenodesis (LET) and anterolateral ligament reconstruction (ALLR), in combination with ACLR in skeletally immatures.ResultsTwenty studies were included after screening 1.485 abstracts. Seventeen studies describe LET techniques, four studies ALLR techniques and one study both techniques. Biomechanical data is scarce and shows conflicting results. Two studies compared ACLR with LET to ACLR in skeletally immatures with promising results in favour of the combined procedure. There were no differences in outcomes between LET and ALLR.ConclusionsSeveral LET and ALLR techniques have been described for skeletally immature patients and the first clinical data on LET and ALLR is available, which showed promising results. Further research is necessary to evaluate the risk of growth disturbances and overconstraint in skeletally immatures.Level of EvidenceLevel IV.

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2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

Cited by 88 publications

References 149 publications

Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Maximal Isometric or Eccentric Hamstring Strength—Which Test Modality Might Be More Suitable for Assessments in Youth Alpine Ski Racers?

Anterolateral augmentation procedures during anterior cruciate ligament reconstructions in skeletally immature patients: Scoping review of surgical techniques and outcomes

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