According to an evaluation of 2-year clinical outcomes from adolescent patients who underwent primary ACL reconstruction, those who were predominantly 8th and 9th graders had a higher rate of revision ACL reconstruction and a lower return to sport rate.

The study, conducted by researchers from Hospital for Special Surgery (HSS), included more than 300 adolescent ACL reconstruction patients. They were assessed in three groups based on the amount of skeletal growth remaining.

Group 1 was comprised mainly of elementary and middle school athletes up to 7th grade (3 to 6 years left of growth), Group 2 were 8th and 9th graders (2 to 3 years left of growth), and Group 3 included high school and young collegiate athletes (fully grown).

Group 1 saw a 6% rate of revision and a perfect 100% return to sport. Group 3 demonstrated similar results (6% revision rate, 94%return to sport).

However, according to the researchers, in a media release from HSS, Group 2 saw a much higher 20% revision rate and only a 86% return to sport rate.

“There could be multiple factors associated with the less successful outcomes we observed in the Group 2 athletes,” says Frank Cordasco, MD, MS, sports medicine surgeon at HSS and senior study author, in the release.

“This Group 2 cohort bridges the divide between middle school and high school. At this age, when you miss a season and re-join your teammates in a competitive high school athletic environment, you have not developed the same sports-specific skills that this non-injured group did during the gap year, which can lead to another injury.”

This study illustrates the need for stronger communication to parents, coaches, PTs and athletic trainers about the risk of ACL injuries in this age group, the researchers note.

“If an 8th or 9th grader walks into a doctor’s office with a torn ACL, the high risk needs to be communicated to the family,” states Daniel Green, MD, MS, FAAP, FACS, pediatric orthopedic surgeon at HSS and senior study author.

“Conversely, if it’s a younger middle school athlete, the success rate is pretty good.”

The recovery period is just as important when looking at preventing re-tears and returning to sport.

“To achieve optimal results after surgery, we counsel our patients to complete an ACL prevention injury program,” Green adds. “It’s very important that these athletes only return to sports after they have regained great physical shape and learned prevention techniques.”

The study was presented during the recent American Academy of Orthopaedic Surgeons (AAOS) annual meeting.

[Source(s): Hospital for Special Surgery, PR Newswire]