Contralateral Anterior Cruciate Ligament Injuries Following Index Reconstruction in the Pediatric Athlete
- PDF / 360,805 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 58 Downloads / 245 Views
HOT TOPICS
Contralateral Anterior Cruciate Ligament Injuries Following Index Reconstruction in the Pediatric Athlete Benjamin T. Gaal 1 & Derrick M. Knapik 2,3 & Michael R. Karns 2,3 & Michael J. Salata 2,3 & James E. Voos 2,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The purpose of this review is to discuss relevant anatomy and pathoanatomy in the knee following anterior cruciate ligament reconstruction, risk factors for contralateral ACL tear, and mechanisms of contralateral injuries in the pediatric population. Recent Findings Contralateral ACL rupture rates following ACL reconstruction (ACLR) range from 4% to 42%. Pediatric patients show increased risk compared with adults, likely due to inherent anatomical differences along with biomechanical and neuromuscular changes that occur in both the operative and contralateral knees following index ACLR. Pediatric athletes who return to sport more quickly have been found to be at increased risk for contralateral tears, as have athletes who participate in cutting and pivoting sports. Contralateral tears tend to occur via non-contact mechanisms. Summary Pediatric patients are at increased risk of contralateral ACL injury following index ACL reconstruction compared with adults. Further study is warranted to determine appropriate biologic, functional, and rehabilitative parameters gauged toward preventing contralateral ACL tear while minimizing time lost from sport. Keywords Anterior cruciate ligament injury . Contralateral ACL . Pediatric athlete . Skeletally immature
Introduction Anterior cruciate ligament (ACL) tears represent one of the most frequently encountered injuries in athletes, with approximately 200,000 ACL tears diagnosed annually [1]. ACL injury rates remain disproportionately high in the pediatric population (age < 18), occurring in approximately 50:100,000 youth athletes each year [2, 3] (Fig. 1). The diagnosis of ACL injuries and subsequent ACL reconstruction (ACLR) procedures have increased significantly over the last two decades [4]. This increase has been attributed to increasing numbers of pediatric athletes participating in sports, year round sport participation, along with greater emphasis on single-
* Derrick M. Knapik [email protected] 1
Case Western Reserve University School of Medicine, Cleveland, OH, USA
2
University Hospitals Sports Medicine Institute, Cleveland, OH, USA
3
Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
sport specialization, coupled with improvements in advanced imaging and diagnosis of ACL injury [4–7]. Following ACLR, injuries to the contralateral ACL have been reported to occur in 4 to 42% of pediatric patients [8•, 9], accounting for 0.5 to 3% of all ACL injuries in the pediatric population [10]. Contralateral ACL injuries require further surgery, necessitating prolonged rehabilitation and time lost from sport [11, 12, 13••, 14, 15]. To date, few studies have examined contralateral ACL injuries in th
Data Loading...
