ACL reconstruction in adolescents has outcomes comparable to healthy controls
Patients who underwent ACL reconstruction during adolescence experienced significantly more radiographically visible osteoarthritic changes in their operated knee vs. the uninvolved contralateral knee in the long term, with clinical outcomes and health-related quality of life similar to that seen in healthy controls, according to researchers.
The researchers evaluated 32 adolescent patients (mean age: 15.2 years) with symptomatic unilateral ACL ruptures. All patients underwent reconstruction with either the bone-patellar tendon-bone technique or hamstring tendon technique at an almost skeletally mature age based on Tanner stage 4 criteria. The mean time between injury and index operation was 11.6 months.
At follow-up, the researchers assessed patients based on Lysholm knee score, Tegner activity level and SF-36. Knee symptoms and functions were rated with KOOS, and overall health status was measured with the EuroQol (EQ-5D). Overall, 29 patients were assessed clinically, radiographically and for health-related quality of life (HR-QoL) after 10 to 20 years.
Results showed patients’ reconstructed knees had significantly more osteoarthritic changes compared with contralateral, uninvolved knees. Compared with median preoperative Tegner activity level and Lysholm knee scores of 4 and 75, respectively, patients’ median postoperative scores were 4 and 84, respectively. The researchers concluded the preoperative vs. follow-up differences were not significant. Additionally, muscle strength measurements at follow-up were more than 90% of noninvolved leg in both extension and flexion, according to the researchers.
Lachman test results had improved significantly at the follow-up compared with preoperative results, and SF-36 scores were comparable to those of the healthy controls, the researchers reported. The mean EQ-5D score was 0.86, and KOOS values were lower compared with the age-matched controls in all areas measured. – by Monica Jaramillo
Disclosures: Månsson reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.