2025 ISAKOS Biennial Congress ePoster
Sport Specific Outcomes, Concomitant Injuries, and Return to Sport Rates After Pediatric and Adolescent ACL Reconstruction
Philipp Wilhelm Winkler, MD, Assoc. Prof., Linz AUSTRIA
Baldur Thorolfsson, MD, Gothenburg SWEDEN
Ramana Piussi, PhD, Göteborg, Sverige SWEDEN
Thorkell Snaebjörnsson, MD, Reykjavik ICELAND
Rebecca Simonsson, PT, MSc, Västra Frölunda SWEDEN
Jon Karlsson, MD, PhD, Prof., Mölndal SWEDEN
Kristian Samuelsson, Prof, MD, PhD, MSc, Mölndal, Västra Götalands län SWEDEN
Eric Hamrin Senorski, PT, PhD, Assoc. Prof., Västra Frölunda SWEDEN
Sahlgrenska Sports Medicine Center, Sahlgrenska Academy, Gothenburg, SWEDEN
FDA Status Not Applicable
Summary
Significant improvements in all KOOS subscales can be expected after pediatric and adolescent ACL reconstruction, regardless of the type of sport.
ePosters will be available shortly before Congress
Abstract
Purpose
Early sport specialization becomes increasingly popular and is associated with an increased prevalence of anterior cruciate ligament (ACL) injury. The purpose of this study was to evaluate sport specific outcomes, concomitant injuries, and return to sport (RTS) rates after pediatric and adolescent ACL reconstruction based on the Swedish National Knee Ligament Registry (SNKLR).
Methods
This study included patients aged between 10 and 18 years at the time of primary ACL reconstruction who were registered in the SNKLR. Demographic, injury-related, and treatment-specific data as well as Knee injury and Osteoarthritis Outcomes Score (KOOS) subscales at baseline and at the one- and two-year follow-ups were obtained. A study specific survey with 33 questions to assess sport specific outcomes and RTS rates was developed by experts in the management of ACL injuries and sent to eligible patients who at the time of distribution were older than 20 years. The collected data were analyzed and stratified by the most popular types of sport in the study cohort.
Results
Overall, 1,567 patients with a mean age of 16.3 ± 1.4 years at the time of ACL reconstruction were included in this study. The most prevalent type of sport was soccer (n=819), followed by handball (n=203), floor hockey/field hockey (n=146), basketball (n=71), and other type of sports (n=328). Concomitant meniscus injuries were most commonly observed, with medial and lateral meniscus injuries occurring in 24% and 28% of pediatric and adolescent patients, respectively. Significant differences in the prevalence of concomitant medial collateral ligament injuries were found between the different types of sport (p=0.007), with the highest prevalence seen in handball (5%). Significant improvements were observed in KOOS subscales from baseline to the one- and two-year follow-ups for all types of sport. Second ACL injury was observed in 23% of patients, with the highest frequency observed in floor hockey / field hockey (27%), followed by soccer (25%), handball (24%), basketball (20%), and other type of sports (17%). The proportion of patients who reported they were active at an elite level sport decreased from 40% before the ACL injury to 25% after ACL reconstruction. No RTS after ACL reconstruction was most prevalent in patients playing basketball (11%), followed by soccer (10%), floor hockey/field hockey (10%), handball (8%), and other type of sports (8%).
Conclusion
Concomitant injuries and second ACL injuries are common after pediatric and adolescent ACL reconstruction. After ACL reconstruction, less patients participate in elite level sport than pre-injury. Moreover, 9% of the patients do not RTS at all.