Trends of anterior cruciate ligament reconstruction in children and young adolescents in Italy show a constant increase in the last 15 years

Longo, Umile Giuseppe; Salvatore, Giuseppe; Ruzzini, Laura; Ambrogioni, L.; Viganò, Marco; Facchini, Fiorenzo; Candela, Vincenzo; Ciccozzi, Massimo; Denaro, Vincenzo

doi:10.1007/s00167-020-06203-1

Cited by 20 publications

(21 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Numerous epidemiological studies have demonstrated an increase in the incidence of anterior cruciate ligament (ACL) injuries occurring in pediatric and adolescent patients over the past 2 decades, likely as a result of increased participation in competitive sports. 6,8,29,32,35,46,47 These findings are concerning because rates of secondary ACL injuries are considerably higher than in adult populations. Another issue regarding the management of these patients is the controversy regarding whether operative versus nonoperative treatment is optimum in pediatric patients (except in those who have repairable additional injuries in whom there is agreement that early ACL reconstruction [ACLR] and meniscal repair should be performed).…”

mentioning

confidence: 99%

Isolated ACL Reconstruction Versus ACL Reconstruction Combined With Lateral Extra-articular Tenodesis: A Comparative Study of Clinical Outcomes in Adolescent Patients

Monaco¹,

Carrozzo²,

Saithna³

et al. 2022

Am J Sports Med

View full text Add to dashboard Cite

Background: Young patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) are at a particularly high risk of graft ruptures compared with adults. Recent studies have demonstrated significant reductions in ACL graft rupture rates in high-risk adult populations when a lateral extra-articular procedure is performed, but comparative studies in pediatric and adolescent populations are currently lacking in the literature. Purpose/Hypothesis: The purpose of this study was to compare the clinical outcomes of isolated ACLR versus combined ACLR and lateral extra-articular tenodesis (LET) when using the Arnold-Coker modification of the MacIntosh procedure in early adolescent patients. The hypothesis was that combined procedures would be associated with a significantly reduced risk of graft ruptures. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis of consecutive early adolescent patients who underwent ACLR using a hamstring tendon autograft with or without the Arnold-Coker modification of the MacIntosh procedure was conducted. Patients with ≥1 additional risk factors for a graft rupture were offered LET in addition to ACLR (pivot-shift grade 2 or 3, high level of sporting activity defined as Tegner activity score ≥7, participation in pivoting sports, and Segond fractures). Clinical outcomes including graft rupture rates, patient-reported outcome measure scores (Knee injury and Osteoarthritis Outcome Score and subjective International Knee Documentation Committee), knee stability, return-to-sports rates, reoperation rates, and complications were assessed. Comparisons between variables were assessed with the chi-square or Fisher exact test for categorical variables and the Student or Wilcoxon test for quantitative variables. Multivariate analyses were undertaken to evaluate risk factors for a graft rupture. Results: A total of 111 patients with a mean follow-up of 43.8 ± 17.6 months (range, 24-89 months) were included in the study; 40 patients underwent isolated ACLR, and 71 underwent ACLR + LET. The addition of LET to ACLR was associated with a significantly lower graft rupture rate compared with isolated ACLR (0.0% vs 15.0%, respectively; odds ratio, 15.91 [95% CI, 1.81-139.44]; P = .012). It was also associated with significantly better knee stability (pivot-shift grade 3: 0.0% vs 11.4%, respectively; P = .021) (side-to-side anteroposterior laxity difference >5 mm: 0.0% vs 17.1%, respectively; P = .003) and Tegner activity scores (7 vs 6, respectively; P = .010). There were no significant differences between the groups regarding the Patient Acceptable Symptom State for the patient-reported outcome measures, nor for any of the other outcome measures evaluated, and no differences in the rate of non–graft rupture related reoperations or complications. The ACLR + LET group exceeded the minimal clinically important difference with respect to the Tegner activity scale. Conclusion: In a retrospective comparative cohort study of adolescents, combined ACLR and LET was associated with a significantly lower graft rupture rate and no difference in non–graft rupture related reoperations or complications compared with isolated ACLR.

show abstract

mentioning

confidence: 99%

Isolated ACL Reconstruction Versus ACL Reconstruction Combined With Lateral Extra-articular Tenodesis: A Comparative Study of Clinical Outcomes in Adolescent Patients

Monaco¹,

Carrozzo²,

Saithna³

et al. 2022

Am J Sports Med

View full text Add to dashboard Cite

show abstract

“…So even though this study analyzes the adult population, data from those whose age was 15 years or older were included in the present study (starting from the age group 15–19 years old). The age group 0–14 years old was included in the pediatric and young adult population [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, considering this way of census and the frequency of data updating, the high information content allows the performance of important clinical-epidemiological analyses to evaluate the effectiveness of the assistance provided and potential health planning interventions [ 9 , 10 , 11 , 12 , 13 ].…”

Section: Methodsmentioning

confidence: 99%

Epidemiology of Anterior Cruciate Ligament Reconstruction Surgery in Italy: A 15-Year Nationwide Registry Study

Longo

Nagai

Salvatore

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

There remains little information on the epidemiology of anterior cruciate ligament reconstruction (ACL-R), therefore, we performed an epidemiological evaluation on the ACL-R procedures performed in Italy from 2001 to 2015 to highlight potential disparities in access to healthcare. The National Hospital Discharge records (SDO) maintained at the Italian Ministry of Health were analyzed from 2001 to 2015; 248,234 ACL-Rs were performed in Italy over the 15-year study period in the adult population (starting from 15 years old), and the incidence rate per year in 100,000 persons ranged from 21.70 to 33.60 over the study period. The overall male/female ratio was 4.54. The length of hospitalization ranged from four days in 2001 to two days in 2015. Italy is historically divided into north, center, and south regions, and more than half of ACL-R surgery was performed in the north (67.2%); 95.2% of ACL-Rs were underwent in public institutions. The predicted model projected a slight growth in the number of ACL-Rs in the next 10 years (2016–2025). The number of ACL-R procedures increased in the adult population from 2001 to 2015. The ACL-R procedures were concentrated in the north of Italy, suggesting that efforts on regionalization of ACL-Rs should turn toward improving quality in hospitals in the south of Italy.

show abstract

“…The annual incidence of anterior cruciate ligament (ACL) injuries among young and middle-aged athletes continues to rise, most of which are surgically reconstructed (ACL reconstruction [ACLR]) with the hopes of restoring knee stability and allowing the athlete to return to their preinjury level of sport. 1,2 Unfortunately, between 15% and 35% of ACLR patients who successfully return to sport will sustain a second ACL injury to either their surgical or contralateral limb. 3,4 Along with the risk for second ACL injuries, ACLR patients have an elevated risk for injuring other knee joint structures (e.g., meniscus), 5 developing early signs of osteoarthritis, 6 and having selfreported joint pain and impaired quality of life.…”

Section: Introductionmentioning

confidence: 99%

Landing biomechanics deficits in anterior cruciate ligament reconstruction patients can be assessed in a non‐laboratory setting

Peebles

Miller

Queen

2021

Journal Orthopaedic Research

View full text Add to dashboard Cite

Landing biomechanics provide important information pertaining to second anterior cruciate ligament (ACL) injury risk in patients following ACL reconstruction (ACLR). While traditional motion analysis technologies are often impractical for use in non-laboratory settings, methods to assess landing biomechanics which are inexpensive, portable, and user-friendly have recently been developed and validated. The purpose of this study was to compare landing kinematics and kinetics between ACLR patients and uninjured controls in a non-laboratory setting. Sixteen ACLR patients (7 male/9 female, 6-12 months post-ACLR) and 16 gender-matched controls completed seven bilateral drop vertical jumps and seven unilateral drop landings on each limb. Plantar force was measured bilaterally using force sensing insoles and frontal and sagittal-plane knee kinematics were measured using two tablets, six reflective markers, and automated point tracking software. Plantar force impulse normalized symmetry index (NSI) and knee frontal plane projection angle (FPPA) range of motion were computed during bilateral landing, and knee flexion range of motion NSI was computed during unilateral landing and compared between groups using independent samples t tests. ACLR patients had larger NSIs (reflecting less symmetry) for plantar force impulse during bilateral landing (p < 0.001) and knee flexion range of motion during unilateral landing (p = 0.004). No between-group differences were observed for knee FPPA range of motion (p = 0.111). This study is an important step towards assessing landing biomechanics in non-research settings with the goal of providing quantitative injury risk metrics in a clinical setting that can be used for return to sport decision making.

show abstract

Trends of anterior cruciate ligament reconstruction in children and young adolescents in Italy show a constant increase in the last 15 years

Cited by 20 publications

References 28 publications

Isolated ACL Reconstruction Versus ACL Reconstruction Combined With Lateral Extra-articular Tenodesis: A Comparative Study of Clinical Outcomes in Adolescent Patients

Isolated ACL Reconstruction Versus ACL Reconstruction Combined With Lateral Extra-articular Tenodesis: A Comparative Study of Clinical Outcomes in Adolescent Patients

Epidemiology of Anterior Cruciate Ligament Reconstruction Surgery in Italy: A 15-Year Nationwide Registry Study

Landing biomechanics deficits in anterior cruciate ligament reconstruction patients can be assessed in a non‐laboratory setting

Contact Info

Product

Resources

About