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Kids Who Delay ACL Reconstructive Surgery At Increased Risk of Other Knee Injuries

Consistent with previous studies

Young athletes who delay ACL reconstructive surgery more than 150 days after injury experience higher rates of other kinds of knee injuries, including medial meniscal tears, say a new study presented to the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day in San Francisco, California.

"In our research, children who had delayed treatment of an ACL injury more than 150 days, tended to have an increased chance of also having a medial meniscus or chondral injury in their knee. These additional injuries may increase recovery time, inhibit return to play, and worsen long term functional outcomes of the knee," said lead researcher, Guillaume D. Dumont, MD of the University of Texas Southwestern Medical Center in Dallas, Texas. "This finding may also be relevant when counseling patients and their families regarding timing for injury treatment."

The researchers analyzed records from 370 patients who underwent ACL reconstruction between January 2005 and January 2011 at Children's Medical Center of Dallas. 200 patients were more than 15 years old and 170 patients were less than 15 years old. There were 208 male patients and 162 female patients involved in the study. Patients were injured in a variety of athletic activities: football (29.7%), basketball (20.2%), soccer (17.6%), cheerleading/gymnastics (4.3%), and other (28.1%). Female soccer player with knee brace

"Weight also appeared to be a factor associated with the rate of meniscal tears found at the time of surgery," comments senior author, Philip Wilson, MD. "Our data demonstrates patient weight over 143 lbs (65 kg) to be associated with an increased rate of medial and lateral meniscal tears at the time of surgery. With recent significant increases in child and adolescent obesity rates, this finding may have significant public health implications."

The study also demonstrated a relationship between age and injury, with children more than 15 years old having a higher rate of medial femoral chondral injury. Neither gender nor sport played during injury was found to be associated with an increased rate of injury in the study.

The new study is consistent with studies in adult populations and a 2009 paper presented at the same conference which found that a delay of more than 12 weeks by athletes under the age of 14 in having ACL surgical reconstruction was linked to:

  • a 4-fold increase in irreparable tears of the medial meniscus;
  • an 11-fold increase in lateral compartment injuries;
  • a 3-fold increase in patellotrochlear injuries; and
  • a significant increase in knee instability.

Source: American Orthopaedic Society for Sports Medicine

Posted February 14, 2012