ACL injuries before 15 years of age: could the young become an athlete?

Morvan, Antoine; Bouguennec, Nicolas; Graveleau, Nicolas

doi:10.1007/s00402-020-03404-8

Cited by 11 publications

(11 citation statements)

References 46 publications

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“…In a Danish registry study, the revision rate in the age group of 13–15 years was 6.7% [ 26 ]. In a review by Morvan et al, a re-rupture rate of 16% was seen in patients under 16 years of age [ 27 ]. Ho et al found graft failure rates of 17% in skeletally immature patients, when graft failures were confirmed by clinical examination and magnetic resonance imaging, or by ACL revision surgery [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term evaluation of pediatric ACL reconstruction: high risk of further surgery but a restrictive postoperative management was related to a lower revision rate

Hansson

Moström

Forssblad

et al. 2021

Arch Orthop Trauma Surg

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Introduction The guidelines regarding rehabilitation after pediatric anterior cruciate ligament reconstruction (ACLR) are sparse. The aim of the study was to retrospectively describe the long-term outcome regarding further surgery and with special emphasis on the revision rate after two different postoperative rehabilitation programs following pediatric ACLR. Material and methods 193 consecutive patients < 15 years of age who had undergone ACLR at two centers, A (n = 116) and B (n = 77), in 2006–2010 were identified. Postoperative rehabilitation protocol at A: a brace locked in 30° of flexion with partial weight bearing for 3 weeks followed by another 3 weeks in the brace with limited range of motion 10°–90° and full weight bearing; return to sports after a minimum of 9 months. B: immediate free range of motion and weight bearing as tolerated; return to sports after a minimum of 6 months. The mean follow-up time was 6.9 (range 5–9) years. The mean age at ACLR was 13.2 years (range 7–14) years. The primary outcome measurement in the statistical analysis was the occurrence of revision. Multivariable logistic regression analysis was performed to investigate five potential risk factors: surgical center, sex, age at ACLR, time from injury to ACLR and graft diameter. Results Thirty-three percent had further surgery in the operated knee including a revision rate of 12%. Twelve percent underwent ACLR in the contralateral knee. The only significant variable in the statistical analysis according to the multivariable logistic regression analysis was surgical center (p = 0.019). Eight percent of the patients at center A and 19% of the patients at B underwent ACL revision. Conclusions Further surgery in the operated knee could be expected in one third of the cases including a revision rate of 12%. The study also disclosed a similar rate of contralateral ACLR at 12%. The revision rate following pediatric ACLR was lower in a center which applied a more restrictive rehabilitation protocol. Level of evidence Case-control study, Level III.

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Section: Discussionmentioning

confidence: 99%

Long-term evaluation of pediatric ACL reconstruction: high risk of further surgery but a restrictive postoperative management was related to a lower revision rate

Hansson

Moström

Forssblad

et al. 2021

Arch Orthop Trauma Surg

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“…The quality of the SATs was assessed by the MINORS scale, with scores less than 9 implied low-quality, scores between 9 and 12 implied moderate quality, while those more than 12 implied high-quality. 9 The MINORS scale was completed by two investigators and then averaged as the scale process is complicated. The results were cross-checked.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review – Are They Potential Eradication Regimens?

Wang¹,

Tang²,

Zhou³

et al. 2022

IDR

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Background Rifaximin, a rifamycin antibiotic, is widely used to treat infectious diarrhea but not commonly used in H. pylori eradication. With its potential advantages of the agent, some studies were conducted on this topic. The aim of this study is to assess effectiveness and safety of rifaximin-containing regimens and to evaluate whether they are alternative choices for H. pylori eradication. Methods Scientific databases including PubMed, EMbase and Cochrane Library were used to identify clinical trials on rifaximin-containing regimens published from January 2000 to October 2021. Review Manager 5.4 and STATA12 were adopted for the systematic review. Results In this study, totally 1025 patients were included from 3 randomized controlled and 9 single-arm studies. It showed that the differences in effectiveness and safety between rifaximin-containing and first-line regimens were not statistically significant in randomized controlled trials. However, the results of the single-arm trials indicated that the eradication and adverse drug reaction rate varied suggesting data instability ( r =38.1%-85.4%, r ADR 0.00–67.5% by ITT analysis). Among them, the eradication rate of pediatric patients ( r =85.4% by ITT analysis) was higher than that of adult patients ( r =38.1–74.5% by ITT analysis). Meanwhile, in all adult subgroups (triple or quadruple, with or without amoxicillin, different duration and rifaximin dose), the results did not show sufficient effectiveness as all the eradication rates did not meet the minimum ideal or ideal target. Conclusion Taken together, rifaximin-containing regimens should not be recommended for H. pylori eradication as they cannot achieve the eradication rate desired.

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“…More than 90% of pediatric athletes return to sport after ACLR, with up to 81% returning to competitivelevel sport at the preinjury level. 15,101 However, the rate of a second ACL injury in this population is as high as 32%. 17,[102][103][104] The risk is highest within the first 2 years after ACLR.…”

Section: Reinjury Rate Is High In the Youthmentioning

confidence: 89%

Unique Considerations for the Pediatric Athlete During Rehabilitation and Return to Sport After Anterior Cruciate Ligament Reconstruction

Matsuzaki

Chipman

Perea

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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Anterior cruciate ligament (ACL) injuries and surgical intervention in the pediatric population have increased in the recent years. Although surgical techniques have advanced, evidence-based rehabilitation guidelines that consider all aspects of the youth athlete are currently lacking. The purpose of this commentary is to review the current evidence on unique considerations for the pediatric and adolescent population during rehabilitation and return to sport after ACL reconstruction (ACLR), with a focus on children under 18 years of age. This review revealed that returning a youth athlete to sport after ACLR requires knowledge and appreciation of various aspects of the growing athlete different from adults. In addition to postoperative precautions that contribute to a slow rehabilitation process, young athletes need additional time for strength gains. Address risk of reinjury and for contralateral injury by using neuromuscular training and rigorous return-to-sport training programs. Consider return to sport after 9 months because the reinjury rate is high in this population. A combination of time and objective measures, both quantitative and qualitative criteria, and psychological readiness should be used to assess readiness to return to sport and decrease risk of future injury. Healthcare providers should be aware of the psychosocial impact of injury on the youth athletes and refer to sport psychology when necessary. Level of Evidence: Level V.O ver the last 2 decades, anterior cruciate ligament (ACL) injuries and surgical intervention in children and adolescents have been increasing. [1][2][3][4][5][6][7] This increase is often attributed to increased participation in competitive organized sports, 8 early sports specialization, 9 and year-round training and competition. 10 Furthermore, advancements in surgical techniques allow for early reconstruction of the ACL in the

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ACL injuries before 15 years of age: could the young become an athlete?

Cited by 11 publications

References 46 publications

Long-term evaluation of pediatric ACL reconstruction: high risk of further surgery but a restrictive postoperative management was related to a lower revision rate

Long-term evaluation of pediatric ACL reconstruction: high risk of further surgery but a restrictive postoperative management was related to a lower revision rate

Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review – Are They Potential Eradication Regimens?

Unique Considerations for the Pediatric Athlete During Rehabilitation and Return to Sport After Anterior Cruciate Ligament Reconstruction

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