Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injury and Reconstruction

Abstract

Level III-retrospective cohort study.

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

“…These findings support those of studies in other countries, such as the USA, that the rate of ACL injuries in pediatrics and adolescents is increasing [2,7,14,24]. Previous research has reported an increase in the rate of hospital-treated sports injuries in children in the same geographic region over the same period [25].…”

“…For example, studies in the late 1970s and early 1980s reported the incidence of ACL rupture in skeletally immature individuals sustaining a knee injury as being between 1.0% and 3.4% [9,10,11,12]. However, as imaging and clinical awareness of injuries in young athletes has improved, the diagnosis and reported incidence of ACL injury in the skeletally immature population has increased [13], and ACL tears in pediatric and adolescent patients are no longer considered rare [7,14]. Whilst it is possible that improved methods of diagnosis are responsible for greater rates of reconstruction, or that reconstruction rates have increased due to improved methods of treatment in the skeletally immature, it is also possible that the incidence of ACL tears is truly increasing in children and adolescents [2].…”

“…A review of ACL construction rates over 20 years from 1990 to 2009 in New York State found that the rate of ACL reconstruction was eight times more in 15- to 18-year-olds than in 11- to 14-year-olds [2]. Data obtained from a national database in the USA for ACL tears in pediatric and adolescent patients for those who underwent arthroscopic reconstruction between 2007 and 2011 showed that the most significant increases were in 10- to 14-year-olds with an 18.9% increase in the diagnosis of ACL tear ( p < 0.0001) and a 26.7% increase in ACL reconstruction ( p < 0.0001) [14]. A statistically significant increase was also noted in the diagnosis of ACL tears in the 5–9 year-old cohort (4.5% increase, p < 0.0001) [14].…”

“…Data obtained from a national database in the USA for ACL tears in pediatric and adolescent patients for those who underwent arthroscopic reconstruction between 2007 and 2011 showed that the most significant increases were in 10- to 14-year-olds with an 18.9% increase in the diagnosis of ACL tear ( p < 0.0001) and a 26.7% increase in ACL reconstruction ( p < 0.0001) [14]. A statistically significant increase was also noted in the diagnosis of ACL tears in the 5–9 year-old cohort (4.5% increase, p < 0.0001) [14]. Australian data on ACL reconstructions between July 2003 and June 2008 showed a significant linear increase for males in the age group of 5–14 years ( p = 0.005) and also demonstrated that the incidence of ACL reconstruction rose rapidly through adolescence and early adulthood and then gradually declined [5].…”

Anterior cruciate ligament reconstruction in skeletally immature patients

“…A separate analysis that queried a national database showed that from 2007 to 2011 there was a 19 % increase in the number of This article is part of the Topical Collection on Pediatric Orthopedics ACL tears diagnosed in the 10-to 14-year age group and a 28 % increase in ACL reconstruction. The study also revealed that diagnosis and reconstruction of pediatric ACL tears were rising at a rate significantly higher than that of adults [12]. These numbers were similar to that seen in a populationbased study from New York State that revealed that the rate of ACL reconstructions over the last 20 years has more than doubled in patients aged 3 to 20 years [13].…”