Risk of reoperation after primary anterior cruciate ligament reconstruction in children and adolescents

Abstract

Objective: To examine the incidence and risk factors of any-cause reoperation after primary ACLR in children and adolescents. Design: Retrospective Cohort Setting: Electronic medical records from a large tertiary care, single institution integrated healthcare delivery system. Patients: Patients were under the age of 18 years and had anterior cruciate ligament reconstruction. They were excluded if they had a multi-ligamentous knee injury or <1 year follow-up. Interventions: Patients were further identified to have undergone a subsequent knee operation ipsilaterally or contralateral ACLR. Main outcome measures: The rate of any-cause reoperation was our primary outcome measure. Results: The median age was 16. There were 208 females (53.9%) and 178 males (46.1%) included. The median follow-up was 25 months with a minimum of 12 months (interquartile range: 16.0, 46.0). The rate of any-cause reoperation was 34.7%. There was no statistically significant difference between those who underwent reoperation versus those who did not undergo reoperation relative to age, sex, BMI, graft type, or the presence of concomitant meniscal injury. The rates of ipsilateral ACLR and contralateral ACLR at any time during the study period was 8.0% and 10.9% respectively. There was no statistically significant difference for rate of reoperation between graft types, between various concomitant injuries, between those who underwent meniscus repair or no repair. Conclusions: This study reflects a 34.7% rate of a subsequent knee operation after ACLR in patients younger than 18 years. These findings can be used to inform pediatric patients undergoing primary ACLR on their risk of returning to the operating room.