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Rate of return to sport high by 1 year after all-epiphyseal ACL reconstruction in children
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ORLANDO, Fla. — Skeletally immature patients with 3 years to 6 years of remaining growth who underwent all-inside, all-epiphyseal ACL reconstruction demonstrated a 9% failure rate, with most patients returning to sports — but not until an average of 12.5 months postoperatively, according to the findings from a study presented here.
“We found good-to-excellent subjective and objective outcomes in this cohort,” Frank A. Cordasco, MD, said during his presentation at the American Orthopaedic Society for Sports Medicine. “[There was] no evidence of growth disturbance. Qualitative movement assessment … is an important tool to facilitate return to sport by addressing these modifiable factors.”
The study included 23 patients with a mean age of 11.8 years and a mean bone age of 12.1 years. Seventeen patients were boys, and most patients in the study were in grades five through seven. Seventy-eight percent of patients participated in competitive sports, with soccer and lacrosse topping the list, Cordasco said.
At a minimum follow-up of 2 years, the researchers found normal or near-normal Lachman and pivot shift results in all patients. KT-1000 testing showed approximately 1 mm of side-to-side difference. Additionally, mean IKDC score was 94.5, mean Lysholm score was 98.1 and mean Marx activity rating scale score was 12.8. The researchers also found MRIs and standing radiographs demonstrated no significant growth disturbances at 2 years.
“With respect to return to sport, 21 of 23, or 91%, did return to sport. But note, this was at an average of 12.5 months,” Cordasco said. “Second surgery was required in two of 23 [patients], or 9%. One patient had two surgeries, a revision ACL at 10 months and a contralateral ACL at 18 months. One patient required a medial meniscus re-repair and went on, thereafter, to play high school baseball.” – by Gina Brockenbrough, MA
Reference:
Cordasco FA, et al. Paper #50. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-12, 2015; Orlando, Fla.
Disclosure: Cordasco reports receiving royalties from Arthrex and ConMed. He is also a paid consultant for Arthrex.