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Rates of Anterior Cruciate Ligament Re-rupture in Pediatric and Adolescent Patients with and without Patella Alta

Rates of Anterior Cruciate Ligament Re-rupture in Pediatric and Adolescent Patients with and without Patella Alta

Danielle E. Rider, BA, UNITED STATES Anirudh K. Gowd, MS, UNITED STATES Lisa W. Kaplin, DO, UNITED STATES Brian R. Waterman, MD, UNITED STATES

Wake Forest Baptist Medical Center, Winston-Salem, NC, UNITED STATES


2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL

Patient Populations

Sports Medicine

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Summary: No difference in rates of Anterior Cruciate Ligament re-rupture between pediatric and adolescent patients with and without patella alta


Background

The objective of this study was to compare rates of anterior cruciate ligament (ACL) failure between pediatric and adolescent patients to evaluate patella alta as a high risk variable.

Methods

Demographic and surgical data were retrospectively queried for patients =18 years of age with primary ACL reconstruction performed at a single academic center between 2011-2016 and minimum of 2-year clinical surveillance. Patellar height indices, including Caton-Deschamps Index (CDI) and Insall-Salvati Index (ISI), were retrospectively calculated from preoperative imaging to assess the presence of patella alta. Failure was defined as (1) ACL graft re-rupture, (2) grade 2+ Lachman, (3) presence of pivot shift, and (4) side-to-side difference of 3 mm on KT-1000 arthrometer.

Results

A total of 185 patients (84 female, 101 male) and 194 knees were identified, with an average age of 16.2 ± 1.8 years. Of these, 30 (15.46%) experienced ACL failure.

Conclusion

Male sex was associated with increased rates of re-rupture (p = 0.013), but there were no significant findings with regards to age, graft selection technique, or fixation device. There were also no significant differences in rates of ACL re-rupture between pediatric patients with and without patella alta (p = 0.277).

Level of Evidence: IV – Therapeutic case series
Key words: Anterior cruciate ligament, patella alta, Caton-Deschamps Index, Insall-Salvati Index, re-rupture