Over 90 % of children and adolescents return to sport after anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Kay, Jeffrey; Memon, Muzammil; Marx, Robert G.; Peterson, Devin; Simunovic, Nicole; Ayeni, Olufemi R.

doi:10.1007/s00167-018-4830-9

Cited by 136 publications

(121 citation statements)

References 44 publications

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“…The ACL graft revision rate was 5% after 6 years, in agreement with other studies from the Scandinavian4 5 13 and Kaiser Permanente registries 14. The revision rates in the registries are lower than reported from studies of competitive athletes,9–11 possibly since many of the ACL reconstructions in the registries are performed in recreational athletes with a lower activity level than competitive athletes. The revision rate in this study was about 6% after 10 years.…”

Section: Discussionsupporting

confidence: 87%

“…The risk of ACL graft tear has been reported to be much higher for young female football players compared with other female athletes of the same age group with 11% vs 1% graft failure after a mean follow-up of 5.7 years, but the other female athletes did not include handball players 9. High ACL graft failure rates for children and adolescents who return to sport (13% graft rupture after mean 6.5 years) have been reported in a systematic review and meta-analysis 10. In rugby players, the ACL graft failure was 16% after a 5-year follow-up period 11.…”

Section: Introductionmentioning

confidence: 99%

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Similar risk of ACL graft revision for alpine skiers, football and handball players: the graft revision rate is influenced by age and graft choice

et al. 2019

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ObjectivesThe risk of graft revision following ACL reconstruction may depend on the sport type the individuals are engaged in. The purpose of this study was to report the ACL graft revision rate in alpine skiers, football and handball players.Materials and methodsPrimary ACL reconstructions and graft revision data from 2004 to December 2016 were obtained from the Norwegian Cruciate Ligament Registry. The graft survival rates were calculated for individuals in each of the three sport types, for bone patellar tendon bone (BPTB) and hamstring tendons (HT) grafts separately, and related to age at primary operation and sex.ResultsA total of 711 grafts in 14 201 primary ACL reconstructions were revised (5.0%) after median 6 years, 3.8% in alpine skiers, 5.0% in soccer and 6.1% in handball players (p<0.001). Adjusted Cox regression showed similar ACL graft survival rates in the three groups. The HR for graft revision was 5 times higher for individuals aged ≤18 years than for those aged ≥35 years (p<0.001). The corresponding HR for graft type was 1.8 times higher for HT than for BPTB grafts (p<0.001), but 2.8 times higher for individuals aged ≤18 years (p<0.001). The 12 years survival of BPTB grafts was 96% compared with 93% for HT grafts (p <0.001).ConclusionThe revision rate for ACL grafts was similar among alpine skiers, football and handball players, and the results support the use of BPTB grafts in young athletes with closed growth zones in the knee.Study designCohort study; level of evidence, 2.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Similar risk of ACL graft revision for alpine skiers, football and handball players: the graft revision rate is influenced by age and graft choice

et al. 2019

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“…The best available evidence suggests a graft rupture rate in children and adolescents (age range 6–19 years) of 13%, and a contralateral ACL injury rate of 14% 86. It is reasonable to hypothesise that high-quality rehabilitation with high adherence is likely an important step in reducing reinjury risk.…”

Section: Consensus Methodsmentioning

confidence: 99%

2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

et al. 2018

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In October 2017, the International Olympic Committee (IOC) hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. The purpose of this consensus statement was to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America, and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. This consensus statement addresses 6 fundamental clinical questions regarding the prevention, diagnosis, and management of paediatric ACL injuries. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury.

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“…Anterior cruciate ligament (ACL) injury has received a lot of attention due to its potentially severe consequences regarding return-to-sport rates, re-injuries and osteoarthritis development 6,16,73,126 , even though it only represents about 5% of all time-loss injuries in football regardless of sex or playing level 175 . When comparing different sports, the ACL incidence rates were highest in football among girls 51,159 and in lacrosse and American football in boys 51,159 .…”

Section: Injury Surveillancementioning

confidence: 99%

Injury Prevention in Youth Football Players : Training Effects and Programme Implementation

Lindblom

2019

Linköping University Medical Dissertations

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Background With 17-35% of all 14-year-olds in Sweden being active in football, injuries do occur, most frequently during match play. Based on knowledge of injury mechanisms and risk factors, different injury prevention exercise programmes (IPEPs) have been developed. In this thesis, the Swedish IPEP Knee Control was used as a model for injury preventive training. Aim The overall aim of this thesis was to improve our understanding of the effects of the Knee Control injury prevention exercise programme on sports performance and jump-landing technique, as well as exploring programme implementation and coach experiences of using the programme in youth football. Methods Studies I and IV were cluster-randomised trials focusing on the performance effects of Knee Control. Study I included four teams with 41 female youth football players (mean age 14). The intervention group used Knee Control twice weekly for 11 weeks, whereas the control group teams did their usual training. Knee Control includes six different exercises at four levels of difficulty and with partner exercises and is meant to be used during warm-up at every training session. Performance was tested using a battery of balance, agility, jump and sprint tests at baseline and follow-up at an indoor venue. Study IV had a similar setup but included two different interventions: Knee Control and a new, further-developed version of the programme, Knee Control+, which were studied during an eight-week intervention involving eight youth football teams, four male, four female (mean age 14), with 77 players. Similar, but not identical, performance tests were used in Study IV, along with drop vertical jumps and tuck jump assessment to assess jump-landing technique.

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Over 90 % of children and adolescents return to sport after anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Abstract: IV, systematic review of level IV studies.

Cited by 136 publications

References 44 publications

Similar risk of ACL graft revision for alpine skiers, football and handball players: the graft revision rate is influenced by age and graft choice

Similar risk of ACL graft revision for alpine skiers, football and handball players: the graft revision rate is influenced by age and graft choice

2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

Injury Prevention in Youth Football Players : Training Effects and Programme Implementation

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