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Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort

Alexander S. Nicholls, MSc, FRACS
AUSTRALIA

Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort

Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Jillian Lee, BHB, MBChB, FRACS (Ortho), NEW ZEALAND Yoong Lim, BEng, PhD, AUSTRALIA Quang Dao, FRACS, AUSTRALIA

Sydney Orthopaedic Research Institute, Sydney, NSW, AUSTRALIA

2021 Congress Abstract Presentation 6 minutes Not yet rated

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Instability

Treatment / Technique

Repair / Reconstruction

Ligaments

ACL

Patient Populations

Pediatric / Adolescent Sport Specific Population

Sports Medicine

Basic Science Exercise Physiology Rehabilition / Physical Therapy Biomechanics

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Summary: 12 months after ACLR, most children demonstrate significant deconditioning on their uninjured leg relative to a normative population

Introduction

Return to sport (RTS) functional testing post-ACLR relies on the comparison against the healthy limb (with >90% performance considered satisfactory). Limited normative paediatric population data exists. In addition, the effect of leg dominance in this population is unknown. We hypothesised that the normal limb (uninjured limb) in paediatric patients 12 months post-ACLR would differ from the normal population values, in functional RTS testing. In addition, we hypothesized that limb dominance would account for significantly better functional scores which may account for misleading RTS results post surgery.

Methods

87 healthy children (mean age 14 years 8 months) were recruited from local schools and community sports clubs. This normative group underwent routine RTS functional testing to gain control values. 87 post-ACLR children (matched for age, height, weight and Tegner activity level) underwent RTS functional testing in our research institute. Study participants in both groups carried out the following functional tests: knee range of motion, hamstring strength, quadriceps strength, hop for distance, hop for height and cross-over hop. Differences between the normal (uninjured) limb of the post-ACLR group and the normal healthy group were highlighted. The effect of leg dominance on RTS testing performance was also assessed within the normal group.

Results

The normal limb of the post-ACLR group performed significantly worse than the normal (control) population in all functional testing results hamstring strength (control, 85.33±42.84 Nm; non-injured ACLR, 52.3±45.23 Nm; p=0.0001), quadriceps strength (control, 183.6±75.6 Nm; non-injured ACLR, 143.16±115.98 Nm; p=0.02), hop for distance (control, 86.52±28.19 cm; non-injured ACLR, 61.84±25.6 cm; p=0.0001) and hop for height (control, 24.8±7.15 cm; non-injured ACLR, 21.76±7.48cm; p=0.0001). Leg dominance in the normal population significantly positively effects quads strength (4% higher in dominant limb; dominant, 315.1±99.4Nm; non-dominant, 302.9±92.2Nm; p=0.006), triple hop (3% higher in dominant limb; dominant, 434.2±88.1cm; non-dominant, 423.2±87.0cm; p=0.006) and hop height (7% higher in dominant limb; dominant, 23.8±8.8cm; non-dominant, 22.2±7.9cm; p=0.01), but has no significant effect on other tests.

Conclusion

RTS functional testing at 12 months post-ACLR demonstrates deconditioning in the normal limb relative to a healthy age-matched paediatric population. This may imply contralateral injury risk and consideration should be given to longer rehabilitation periods. The effect of limb dominance in the paediatric population does not significantly affect outcome of RTS testing. Hence, limb dominance is unlikely to cause false positives or false negatives in the RTS testing.

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Predicting Subjective Failure of ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register and Patient Reported Outcomes Award Winner 5 minutes R. Kyle Martin, MD, FRCSC, UNITED STATES Solvejg Wastvedt, BA, UNITED STATES Ayoosh Pareek, MD, UNITED STATES Andreas Persson, MD, PhD, NORWAY Havard Visnes, MD, PT, PhD, NORWAY Anne Marie Fenstad, MSc, NORWAY Gilbert Moatshe, MD, PhD, NORWAY Julian Wolfson, PhD, UNITED STATES Lars Engebretsen, MD, PhD, NORWAY
Local Anaesthetic Infiltration (Lia) Is Equally Effective As Adductor Nerve Blocks For Pain Relief In Anterior Cruciate Ligament (Acl) Reconstructions. Abstract Presentation 8 minutes Mohammad Abou Salhab, MBChB, MSc, UNITED KINGDOM Sonal Sonwalkar , FRCA, UNITED KINGDOM Sanjeev Anand, MD, UNITED KINGDOM Martin Stone, MD, UNITED KINGDOM
Posterior Tibial Plateau Impaction Fractures Are Not Associated With Increased Knee Instability: A Quantitative Pivot Shift Analysis Abstract Presentation 8 minutes Brian M Godshaw, MD, UNITED STATES Joshua C Setliff, BA, UNITED STATES Jonathan D Hughes, MD, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
Risk Factors for Grade 3 Pivot Shift in Acute ACL-Injured Knees Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Edoardo Monaco, MD, ITALY Edoardo Gaj, MD, ITALY Valerio Andreozzi, ITALY Alessandro Annibaldi, MD, ITALY Alessandro Carrozzo, MD, ITALY Thais Dutra Vieira, MD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, FRANCE Andrea Ferretti, Prof., ITALY
Combined Reconstruction Of The Medial Collateral Ligament And Anterior Cruciate Ligament Using Ipsilateral Semitendinosus Tendon And Opposite Semitendinosus With Ipsilateral Gracilis Tendon: A Minimum One-Year Follow-Up Study In NITOR.Dhaka,Bnagladesh Abstract Presentation 4 minutes Dibakar Sarkar, MS(Orthopaedic surgery),FACS(USA),AO fellow(Bangko, BANGLADESH
Effect Of Graft Choice On 6-Year Outcomes Of Revision Anterior Cruciate Ligament Reconstruction In The Multicenter ACL Revision Study (Mars) Cohort Abstract Presentation 6 minutes Rick W. Wright, MD, UNITED STATES
Survivability Of Primary Anterior Cruciate Ligament Reconstructions In A Physically High Demand Population Abstract Presentation 6 minutes Ashley Bee Anderson, MD, UNITED STATES Travis Dekker, MD, UNITED STATES Veronika Pav, MS, UNITED STATES Timonthy C Mauntel, PhD, UNITED STATES Matthew T. Provencher, MD, UNITED STATES John M. Tokish, MD, UNITED STATES Jon F. Dickens, MD, UNITED STATES
In Vivo Measurement of Anterior Cruciate Ligament Elongation and Strain Rate during Increasingly Demanding Activities ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Caiqi Xu, MD, CHINA Tom Gale, MS, UNITED STATES William Anderst, PhD, UNITED STATES Freddie H. Fu, MD, UNITED STATES
Acl Deficiency Influences Medio-Lateral Tibial Alignment And Knee Varus–Valgus During In Vivo Activities Abstract Presentation 3 minutes Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Alberto Grassi, PhD, ITALY Marco Bontempi, PhD, ITALY Erika Pinelli, MsC, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Xenograft For Anterior Cruciate Ligament Reconstruction Was Associated With High Graft Processing Infection. Abstract Presentation 6 minutes Willem M. van der Merwe, MBChB, FCS(SA)Ortho, SOUTH AFRICA Martin Lind, MD, PhD, Prof., DENMARK Peter Faunoe, MD, DENMARK Kees van Egmond, MD, NETHERLANDS Stefano Zaffagnini, MD, Prof., ITALY Maurilio Marcacci, MD, ITALY Ramon Cugat Bertomeu, MD, PhD, SPAIN Rene E. Verdonk, Prof Em, MD, PhD, BELGIUM Ernique Ibanez, MD, PhD, SPAIN Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Combined ACL and Anterolateral Ligament Reconstruction Confers Significantly Improved Long Term Outcomes when Compared to Isolated ACL Reconstruction: A Matched-Pair Analysis Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Ibrahim Haidar, MD, LEBANON Johnny Rayes, MD, MSc, FEBOT, CANADA Thomas Fradin, MD, FRANCE Cédric Ngbilo, MD, SWITZERLAND Benjamin Freychet, MD, FRANCE Thais Dutra Vieira, MD, FRANCE Herve Ouanezar, MD, UNITED ARAB EMIRATES Bertrand Sonnery-Cottet, MD, PhD, FRANCE

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Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort

Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort

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Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort

Return To Sports After Paediatric Anterior Cruciate Ligament Reconstruction (ACLR): Normal Population Vs An ACLR Cohort

Introduction

Methods

Results

Conclusion

More ISAKOS 2021: Global Content