Background: Recent literature on arthrofibrosis after anterior cruciate ligament reconstruction (ACLR) in children and adolescents is limited, especially with regards to quadriceps tendon (QT) autograft. The purpose of this study was to identify predictors of arthrofibrosis after ACLR, with attention to the impact of graft type.
Methods: Patients that underwent primary ACLR at a tertiary children's hospital were reviewed for this retrospective case-control study. Those with multiligament reconstructions, lateral extra-articular tenodesis procedures, allografts, or a modified MacIntosh reconstruction were excluded. Arthrofibrosis was defined as a deficit of 10 degrees of extension and/or 20 degrees of flexion at 3 months after ACLR. Univariate analysis was followed by purposeful entry logistic regression to adjust for confounding factors.
Results: A total of 378 patients (mean age 15.9±1.7 y, 49.7% female) were included in the analysis, of which there were 180 patellar tendon (PT), 103 hamstrings tendon (HT), and 95 QT grafts. The rate of arthrofibrosis was 1.9% for HT, 6.3% for QT, and 10.0% for PT (P=0.04). Females developed arthrofibrosis more frequently than males (10.6% vs. 3.2%, P=0.004). Those that ultimately experienced this complication had lower median flexion at 6 weeks after ACLR (88 vs. 110 degrees, P<0.001). In multivariate analysis, PT graft raised the odds of arthrofibrosis 6.2 times compared to HT [95% confidence interval (CI): 1.4-27.6, P=0.02], but there were no significant differences between QT and other grafts. Females were at 4.2 times higher odds than males (95% CI: 1.6-10.8; P=0.003). Patients that were unable to attain 90 degrees of flexion 6 weeks after ACLR had 14.7 times higher odds of eventually developing arthrofibrosis (95% CI: 5.4-39.8; P<0.001). Finally, those with an extension deficit of ≥5 degrees 6 weeks after ACLR had 4.7 times higher odds of experiencing this complication (95% CI: 1.8-12.2, P=0.001).
Conclusion: The rate of arthrofibrosis with QT autograft is 6.3% after pediatric ACLR. PT autograft, female sex, and motion deficits at 6 weeks after ACLR were predictive of arthrofibrosis in children and adolescents.
Level Of Evidence: Level III-prognostic study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BPO.0000000000001860 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictors and Early Treatment of Knee Arthrofibrosis After Arthroscopic Knee Ligament Reconstruction Surgery in Adolescent Patients.
Orthop J Sports Med
December 2024
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Background: Postoperative knee arthrofibrosis after arthroscopic ligament reconstruction is a serious complication. Among adolescents, risk factors for postoperative arthrofibrosis are not well characterized and the effectiveness of early manipulation under anesthesia (MUA) is not well established.
Purposes: To identify risk factors for arthrofibrosis after arthroscopic knee ligament reconstruction in adolescent patients and to evaluate the safety and effectiveness of early MUA.
Predictors of Increased Complication Rate Following Tibial Tubercle Osteotomy (TTO).
Knee
December 2024
NYU Langone Health, Department of Orthopedics, Division of Sports Medicine, 333 E 38th St, New York, NY 10016, United States.
Purpose: The purpose of the current study was to define the incidence of minor and major complications following TTO at a tertiary-care institution, with determination of predictive factors related to the occurrence of a major complication.
Study Design: Retrospective case series.
Methods: Patients who underwent TTO from 2011 to 2023 were retrospectively identified.
Risk factors for failure of manipulation under anesthesia after total knee arthroplasty.
Eur J Orthop Surg Traumatol
August 2024
University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
Background: Manipulation under anesthesia (MUA) is a well-established treatment for stiffness after total knee arthroplasty (TKA). Risk factors for failure of MUA remain largely unknown. The primary aim of this study was to identify risk factors for failure of MUA after TKA.
View Article and Find Full Text PDFValidating the capture rate of revisions by the New Zealand ACL Registry: An analysis of all-cause reoperation following primary ACL reconstruction.
Knee Surg Sports Traumatol Arthrosc
November 2024
Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Purpose: To validate the New Zealand Anterior Cruciate Ligament (ACL) Registry's capture rate of revisions by cross-referencing Registry data with reoperations data recorded by the Accident Compensation Corporation (ACC) and identify risk factors for all-cause reoperation.
Methods: Primary ACL reconstructions performed between April 2014 and September 2019 were individually matched on a record-by-record basis between the two databases. The ACC database was used to identify patients who underwent a reoperation with manual review of operation notes to identify whether a revision or other procedure was performed.
Trends in Elbow Ulnar Collateral Ligament Repairs and Reconstructions and an Analysis Between Low- and High-Volume Surgical Centers: A 10-Year Study in New York State.
Orthop J Sports Med
May 2024
Department of Sports Medicine, NYU Langone Health, New York, New York, USA.
Article Synopsis
- Elbow ulnar collateral ligament (UCL) reconstruction (UCLR) is the preferred surgery for UCL tears, with a growing interest in UCL repairs; the study looks at trends in these surgeries and factors affecting complications.
- The research analyzed data from New York State healthcare facilities from 2010-2019, comparing surgical outcomes based on demographic information, socioeconomic factors, and the volume of surgical procedures at different centers.
- Results indicated a higher frequency of UCLR compared to UCL repairs; patients undergoing repairs tended to be older and female, while high-volume centers had younger male patients and were associated with fewer complications.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!