Similar outcomes after anterior cruciate ligament reconstruction in paediatric and adult populations: a 1‐year follow‐up of 506 paediatric operations in Denmark

Abstract

AbstractPurposeTo present 1‐year results after all paediatric anterior cruciate ligament (ACL) reconstructions in Denmark (5.9 M inhabitants) for the 10½ year period, 1 July 2011 to 31 December 2021.MethodsAll children who had an ACL reconstruction were enrolled. They were asked to complete Pedi‐IKDC preoperatively and at 1‐year follow‐up. Independent observers performed pivot shift test and instrumented laxity assessment preoperatively and at 1‐year follow‐up.ResultsThe median age of the 506 children (47.2% girls) was 14.3 years (9.3–15.9). The Pedi‐IKDC score increased from preoperatively 61.6 ± 15.8 (mean ± SD) to 85.9 ± 13.0 at 1‐year follow‐up (p < 0.0001). There were concomitant injuries (to meniscus and/or cartilage) in 49.9%, but these children had preoperative and follow‐up Pedi‐IKDC scores similar to the scores for children with isolated injury to ACL (n. s.). Instrumented anterior laxity was 4.3 ± 1.4 (mean ± SD) mm preoperatively and 1.4 ± 1.4 mm at follow‐up (p < 0.0001). Preoperatively, 3% had no pivot shift whilst this was the case for 68% postoperatively (p < 0.0001). Twenty‐five children (5.6%) had 4 mm instrumented laxity or more relative to the unoperated knee at follow‐up. Two patients (0.4%) had an operatively treated deep infection, three (0.5%) were operated on for reduced range of motion and two (0.4%) had a revision ACL reconstruction.ConclusionACL reconstruction resulted in a clinically meaningful increase in Pedi‐IKDC, an improved instrumented stability, a reduction in the grade of pivot shift and the complication rate was low at 1‐year follow‐up. The risk of graft insufficiency at 1‐year follow‐up was the same as in an adult population.Level of EvidenceII.