2025 ISAKOS Biennial Congress ePoster
Factors Influencing Return to Sport 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
Cartilage injury at the time of pediatric and adolescent ACL reconstruction is a negative predictor of return to sport.
ePosters will be available shortly before Congress
Abstract
Purpose
Anterior cruciate ligament (ACL) injury in young athletes is often considered to be a career-threatening condition. In spite of much research, there is a lack of evidence on this topic, especially when it comes to children and adolescents. The purpose of this study was to evaluate clinical outcomes, the level and rate of return to sport (RTS), and predictive factors for RTS after pediatric and adolescent ACL reconstruction.
Methods
Patients aged between 10 and 18 years at the time of primary ACL reconstruction that were registered in the Swedish National Knee Ligament Registry (SNKLR) were screened for eligibility. Based on the age at time of ACL reconstruction, patients were divided into pediatric (females: 11-13 years; males: 11-15 years) and adolescent (females: 14-18 years; males: 16-18 years) patients. Demographic, injury-related, and treatment-specific data, and subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline and the one-, two-, five- and 10-year follow-ups were obtained from the SNKLR. A survey developed by experts in the management of ACL injuries was sent to all patients to determine sport specific variables and RTS rates.
Results
Overall, 1,567 patients were included in this study. There were 113 pediatric patients (mean age at ACL reconstruction, 13.8 ± 1.4 years) and 1,454 adolescent patients (mean age at ACL reconstruction, 16.5 ± 1.2 years). There were significantly more female patients in the adolescent group than in the pediatric group (76% vs. 22%, p<0.0001). Significant improvements in all KOOS subscales were observed after both pediatric and adolescent ACL reconstruction at each follow-up. After ACL reconstruction, 70% of pediatric patients and 66% of adolescent patients returned to their previous type of sport. Moreover, 31% of pediatric patients and 24% of adolescent patients became elite athletes after ACL reconstruction. Cartilage injury at the time of ACL reconstruction was found to lower the odds of pediatric and adolescent patients returning to their previous type of sport (odds ratio, 0.68; p=0.007).
Conclusion
This study showed that 66 to 70% of pediatric and adolescent patients successfully returned to their previous sport after ACL reconstruction. Additionally, 24 to 31% of patients managed to become elite athletes. Although cartilage injury at the time of ACL reconstruction was found to adversely affect RTS, long-lasting (up to 10 years) improvements in all KOOS subscales can be expected after pediatric and adolescent ACL reconstruction.