Open AccessRisk Factors for Failure After Anterior Cruciate Ligament Reconstruction in a Pediatric Population: A Prediction Algorithm
Author(s) -
Nicholas J. Lemme,
Daniel S. Yang,
Brooke Barrow,
Ryan O’Donnell,
Alan H. Daniels,
Aristides I. Cruz
Publication year - 2021
Publication title -
orthopaedic journal of sports medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 35
ISSN - 2325-9671
DOI - 10.1177/2325967121991165
Subject(s) - medicine , anterior cruciate ligament reconstruction , logistic regression , surgery , pediatrics , anterior cruciate ligament
Background: Anterior cruciate ligament reconstruction (ACLR) in pediatric patients is becoming increasingly common. There is growing yet limited literature on the risk factors for revision in this demographic.Purpose: To (1) determine the rate of pediatric revision ACLR in a nationally representative sample, (2) ascertain the associated patient- and injury-specific risk factors for revision ACLR, and (3) examine the differences in the rate and risks of revision ACLR between pediatric and adult patients.Study Design: Case-control study; Level of evidence, 3.Methods: The PearlDiver patient record database was used to identify adult patients (age ≥20 years) and pediatric patients (age 14 years old (OR, 0.62; 95% CI, 0.45-0.86; P = .0035) had a decreased risk of overall reoperation; patients undergoing concurrent meniscal repair (OR, 1.84; 95% CI, 1.43-2.38; P < .0001) or meniscectomy (OR, 2.20; 95% CI, 1.72-2.82; P < .0001) had an increased risk of revision surgery. According to the risk algorithm, the highest probability for revision ACLR was in girls <15 years old with concomitant meniscal and medial collateral ligament injury (36% risk of revision).Conclusion: As compared with adults, pediatric patients had an increased likelihood of revision ACLR, contralateral ACLR, and meniscal reoperation within 5 years of an index ACLR. Families of pediatric patients—especially female patients, younger patients, and those with concomitant medial collateral ligament and meniscal injuries—should be counseled on such risks.