Time to surgery is significant predictor of more procedures after pediatric ACL repair

HOLLYWOOD, Fla. — A delay in surgery greater than 3 months was found to be the only predictive factor of the need for an additional procedure after ACL reconstruction in younger patients, according to a presenter here at the Arthroscopy Association of North America Annual Meeting.

Justin T. Newman, MD, and colleagues from the University of Colorado conducted a retrospective chart review of 272 consecutive patients who had ACL reconstruction during a 7-year period at large tertiary pediatric center. Overall, 66 patients were younger than 14 years. Focal points of the data were operative reports, intraoperative imaging, chronology, return to activity, episodes of instability, meniscal and chondral injury, severity and treatment.

Patients who were more than 3 months out from time of surgery were 4.75 times more likely to require another procedure, a figure that jumped to nearly eight times more likely for another procedure at more than 5 months from surgery.
The younger patients had an average time to surgery of 2.6 months as opposed to 1.7 months for patients older than 14 years. Overall, 57% of patients had additional injuries that required surgery beyond ACL reconstruction. The older patient cohort had a significantly increased percentage of meniscal tears and were significantly more likely to need another procedure following ACL reconstruction. There was also a significant correlation between severity of chondral injury and time to surgery in younger patients that was not present in the older group.

“In those patients under the age of 14 alone, their sports-related injuries cost the U.S. public $49 billion each year,” Newman said. “This [study] has prognostic as well as economic implications.” – by Christian Ingram

Reference:

Newman JT. Paper #SS-13. Presented at: Arthroscopy Association of North America Annual Meeting; May 1-3, 2014; Hollywood, Fla.

Disclosure: Newman has no relevant financial disclosures.