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Pediatric patients experienced worse functional outcomes following revision ACL reconstruction

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BOSTON — Compared with primary ACL reconstruction, pediatric patients who underwent revision ACL reconstruction experienced worse function, lower activity levels, higher rates of graft retear and lower rates of return to sport, according to results presented at the Arthroscopy Association of North America Annual Meeting.

“We found that revision surgery in children and adolescents is associated with suboptimal patient outcomes, high graft retear rates, high complication and return to OR rates, significant risk of contralateral ACL injury and compromised return to sports rates,” Melissa Christino, MD, said in her presentation of the study, which won the Richard J. O’Connor Research Award.

Among 88 patients aged 18 years or younger who underwent a total of 90 revision ACL reconstructions, 74.4% of patients experienced additional intra-articular injuries, including meniscal tears or chondral injuries.

Melissa Christino

“By far, the most common graft used for our revision surgeries was allograft, followed by patellar tendon,” Christino said. “This stands in contrast in hamstring being the most popular choice for [a] primary procedure.”

Christino and her colleagues found a 20% graft re-injury rate, a 25% rate of return to the OR and a 20% contralateral ACL tear rate.

“This rate was even higher among those who then went on to reinjure their revision graft, and that number was 33%,” she said.

Results showed a mean pediatric IKDC score of 77.5, a Lysholm score of 79 and a Tegner score of 6.6. Results also showed a patient satisfaction of slightly higher than 75%.

“We had a 69% return to sport rate in this study, with an average time of return to sport of 8.9 months,” Christino said. “However, of the patients who did go back to sports, only 55% were able to return to the same level and the significant number were unable to return to that same level specifically because of their knee.”– by Casey Tingle

Reference:

Christino M, et al. Paper #SS-10. Presented at: Arthroscopy Association of North America Annual Meeting; April 14-16, 2016; Boston.

Disclosure: Christino reports no relevant financial disclosures.