Return to sport and re-tears after anterior cruciate ligament reconstruction in children and adolescents

Geffroy, Loïc; Lefèvre, Nicolas; Thévenin-Lemoine, Camille; Peyronnet, Antoine; Lakhal, Walid; Fayard, Jean Marie; Chotel, Franck

doi:10.1016/j.otsr.2018.09.006

Cited by 41 publications

(33 citation statements)

References 35 publications

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“…The search identified 4762 articles, of which 4754 were excluded (Appendix Table A2, available online), leaving 8 studies published between 2004 and 2018 for our review. 33,34,50,53,60,86,87,95 Because there were 2 studies from the same institution, 86,89 personal correspondence with the authors resulted in the correct combination of data that avoided duplication. The mean MINORS score was 66% (range, 56%-75%), and the mean Coleman score was 60 points (range, 48-77 points).…”

Section: Resultsmentioning

confidence: 99%

“…The quality of the studies was rated as good in 1, fair in 6, and poor in 1 study. The level of evidence was rated as level 4 in 6 studies, 33,34,50,53,60,87 level 3 in 1, 95 and level 2 in 1 study. 86…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 1083 patients (87%) returned to any sport, of whom 994 (80%) resumed high-risk activities (Table 2). The mean time to RTS was provided in 3 studies 33,86,95 and ranged from 4.6 months 86 to 12.3 months 33 postoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…Validated functional questionnaires were used in 6 studies (Appendix Table A3, available online). Sports or activity level rating assessments (Tegner, 17,96 International Knee Documentation Committee [IKDC], 39 or the Cincinnati Sports Activity Scale 9 ) were used in 4 studies, 33,34,50,53 and nonvalidated sports activity surveys were used in 3 studies. 50,86,87,95…”

Section: Resultsmentioning

confidence: 99%

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One in 5 Athletes Sustain Reinjury Upon Return to High-Risk Sports After ACL Reconstruction: A Systematic Review in 1239 Athletes Younger Than 20 Years

Barber-Westin

Noyes

2020

Sports Health

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Context: Anterior cruciate ligament (ACL) reconstruction (ACLR) is frequently performed in patients younger than 20 years whose goal is to return to sport (RTS). Varying reinjury rates have been reported, and the factors responsible are unclear. Studies differ with regard to age, graft type, surgical techniques, postoperative rehabilitation, RTS guidelines, and methods used to determine ACL failures. Objective: To determine RTS rates; the effect of participation in high-risk sports, sex, and graft type on ACL reinjury rates; and whether objective test criteria before RTS correlate with lower reinjury rates. Data Sources: A systematic review of the literature from inception to May 31, 2019, was conducted using the PubMed and Cochrane databases. Study Selection: Studies on transphyseal ACLR in athletes <20 years old with a minimum mean follow-up of 2 years that reported reinjury rates, the number that RTS, and detailed the type of sport were included. Study Design: Systematic review. Level of Evidence: Level 4. Results: A total of 1239 patients in 8 studies were included; 87% returned to sport and 80% resumed high-risk activities. Of the patients, 18% reinjured the ACL graft and/or the contralateral ACL. Nine percent of patellar tendon autografts and 15% of hamstring autografts failed (odds ratio [OR], 0.52; P = 0.002). Of reinjuries, 90% occurred during high-risk sports. Male patients had a significantly higher rate of ACL graft failure than female patients (OR, 1.64; P = 0.01). There was no sex-based effect on contralateral ACL injuries. Only 1 study cited objective criteria for RTS. Conclusion: A high percentage of athletes returned to sport, but 1 in 5 suffered reinjuries to either knee. Male patients were more likely to reinjure the ACL graft. Objective criteria for RTS were rarely mentioned or not detailed. The need for testing of knee stability, strength, neuromuscular control, agility, and psychological measures before RTS remains paramount in young athletes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

One in 5 Athletes Sustain Reinjury Upon Return to High-Risk Sports After ACL Reconstruction: A Systematic Review in 1239 Athletes Younger Than 20 Years

Barber-Westin

Noyes

2020

Sports Health

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“…＃References 1, 4, 6, 7, 11 –21, 23 –27, 29 –34, 39, 40, 42 –52, 54, 56 –59, 61, 63, 66, 67, 72, 74 –78, 80, 81, 83 –85, 87, 89, 91 –93, 98, 99, 101, 102.…”

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confidence: 99%

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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Optimal Timing of Anterior Cruciate Ligament Reconstruction in Patients With Anterior Cruciate Ligament Tear

Shen

Liu

et al. 2022

JAMA Netw Open

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ImportanceThe timing of surgery has been regarded as a key factor in anterior cruciate ligament reconstruction (ACLR), and early vs delayed ACLR remains a controversial topic.ObjectiveTo synthesize up-to-date published data from randomized clinical trials (RCTs) comparing early vs elective delayed ACLR for patients with ACL deficiency, in terms of clinical outcomes and complications.Data SourcesThe PubMed, Cochrane Library, and Web of Science databases were systematically searched until September 9, 2022.Study SelectionAll published RCTs comparing clinical and functional outcomes and complications associated with early ACLR vs elective delayed ACLR.Data Extraction and SynthesisTwo reviewers independently extracted relevant data and assessed the methodological quality following the PRISMA guidelines.Main Outcomes and MeasuresDue to the clinical heterogeneity, the random-effects model was preferred. The primary outcomes were functional outcomes and complications. The Mantel-Haenszel test was used to evaluate dichotomous variables and the inverse variance method was used to assess continuous variables.ResultsThis meta-analysis included 972 participants in 11 RCTs stratified by follow-up duration. The following factors did not differ between early and delayed ACLR: operative time (mean difference, 4.97; 95% CI, −0.68 to 10.61; P = .08), retear (OR, 1.52; 95% CI, 0.52-4.43; P = .44), and infection (OR, 3.80; 95% CI, 0.77-18.79; P = .10). There were also no differences between groups in range of motion, knee laxity, International Knee Documentation Committee (IKDC rating scale), and Tegner score. IKDC score (mean difference, 2.77; 95% CI, 1.89-3.66; P &lt; .001), and Lysholm score at 2-year follow-up (mean difference, 2.61; 95% CI, 0.74-4.48; P = .006) significantly differed between early and delayed ACLR. In addition, the timing of surgery was redefined in the included RCTs and subgroup analyses were performed, which validated the robustness of the principal results.Conclusion and RelevanceThis systematic review and meta-analysis found that early ACLR was not superior to delayed ACLR in terms of most factors analyzed, except for IKDC and Lysholm scores. This information should be available to patients with ACL deficiency and clinicians as part of the shared decision-making process of treatment selection.

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Return to sport and re-tears after anterior cruciate ligament reconstruction in children and adolescents

Cited by 41 publications

References 35 publications

One in 5 Athletes Sustain Reinjury Upon Return to High-Risk Sports After ACL Reconstruction: A Systematic Review in 1239 Athletes Younger Than 20 Years

One in 5 Athletes Sustain Reinjury Upon Return to High-Risk Sports After ACL Reconstruction: A Systematic Review in 1239 Athletes Younger Than 20 Years

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

Optimal Timing of Anterior Cruciate Ligament Reconstruction in Patients With Anterior Cruciate Ligament Tear

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