Young Athletes With ACL Injuries Often Need Repeat Surgery: Study

Starting athletics early, focusing on just one sport contribute to risks

By Mary Elizabeth Dallas

Friday, May 22, 2015

FRIDAY, May 22, 2015 (HealthDay News) -- Many young athletes who undergo surgery for a torn anterior cruciate ligament (ACL) need a second operation later on, a new study shows.

Torn ACLs are widespread among people younger than 21, said researchers at the Hospital for Special Surgery in New York City.

"This is the first study to evaluate, on a population level, the percentage of patients under age 21 who had subsequent ACL or non-ACL knee surgery following a primary anterior cruciate ligament reconstruction," lead investigator Dr. Emily Dodwell, a pediatric orthopedic surgeon, said in a hospital news release.

Using a New York state database, her team identified 23,912 cases of ACL reconstruction in patients younger than 21. Of these patients, 8 percent needed a second surgery on this ligament, and 14 percent needed another knee surgery that didn't involve their ACL.

The median time between surgeries was roughly 1.5 years, the researchers found.

The study, which followed patients for nearly seven years, was presented recently at the annual meeting of the Pediatric Orthopaedic Society of North America in Atlanta. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

The researchers said the factors associated with a follow-up ACL surgery were similar to those associated with having two unrelated knee surgeries: being younger at the time of injury, being white and male, having private insurance and being treated at a hospital that treats a high volume of ACL injuries.

The actual number of repeat ACL tears may be underestimated since some patients may choose not to have follow-up surgery, the study authors cautioned.

"The increasing rate of ACL injuries is concerning, although not surprising given greater participation in sports," Dodwell said.

Children are starting sports early in life and playing for a long period of time with intensity, the researchers noted. Also, many kids focus on one particular sport throughout the year, resulting in overuse injuries.

"For young people who have primary surgery to reconstruct a torn ACL, it is troubling that they have relatively high rates of subsequent ACL reconstruction or surgery for another knee injury," Dodwell said.

"Further research is needed to determine factors associated with subsequent injury and surgery so we can implement strategies to keep our youth safe while engaging in sports," she added.

SOURCE: Hospital for Special Surgery, news release, May 11, 2015

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