2025 ISAKOS Biennial Congress ePoster
There Is Poor Association Between Preoperative, Intraoperative, And Postoperative Factors At Primary Acl Reconstruction And Revision Acl Reconstruction In Children And Adolescents.
Riccardo Cristiani, MD, PhD, Associate Professor, Stockholm SWEDEN
Gunnar Edman, MD, PhD, Prof., Sollentuna, Sverige SWEDEN
Karl Eriksson, MD, PhD, Prof., Stockholm SWEDEN
Stockholm Sports Trauma Research Center, FIFA Medical Centre of Excellence, Karolinska Institutet, Stockholm, Stockholm, SWEDEN
FDA Status Not Applicable
Summary
A shorter time from injury to primary ACLR is associated with revision ACLR in children and adolescents
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Abstract
Background
There is no comprehensive analysis of preoperative, intraoperative, and postoperative factors at primary anterior cruciate ligament reconstruction (ACLR) associated with revision ACLR in children and adolescents.
Purpose
To evaluate factors associated with revision ACLR within 5 years of primary ACLR in children and adolescents.
Methods
Children and adolescents who underwent primary hamstring tendon (HT) ACLR at our institution during the period 2005-2018, were identified. The outcome of the study was the occurrence of revision ACLR within 5 years of primary ACLR. Univariable and multivariable logistic regression analyses were used to evaluate preoperative [age, sex, pre-injury Tegner activity level, body mass index (BMI), preoperative passive contralateral knee hyperextension (≤-5°), time from injury to surgery, medial collateral ligament injury], intraoperative [medial meniscus (MM) and lateral meniscus (LM) resection or repair, cartilage injury, graft diameter], and postoperative [KT-1000 side-to-side anterior knee laxity, limb symmetry index (LSI) for extension and flexion strength and single-leg-hop performance at 6 months] factors at primary ACLR associated with revision ACLR.
Results
A total of 1,888 patients (mean age 16.0 ± 2.0; range 8-19 years) who underwent primary ACLR were included. The overall incidence of revision ACLR within 5 years was 9.0%. Univariable analysis revealed that time from injury to primary ACLR < 5 months (OR 2.27; 95% CI 1.61 – 2.35; P <0.001) and LM resection (OR 1.49; 95% CI 1.00 – 2.20; P= 0.04) increased the odds of revision ACLR. Multivariable analysis showed that revision ACLR was significantly associated only to time from injury to primary ACLR < 5 months (OR 2.56; 95% CI 1.72 – 3.70; P <0.001).
Conclusion
There is poor association between preoperative, intraoperative, and postoperative factors at primary ACL reconstruction and revision ACL reconstruction in children and adolescents. Time from injury to primary ACLR < 5 months was the only factor associated with revision ACLR within 5 years.