Article

Associated injuries in pediatric and adolescent anterior cruciate ligament tears: does a delay in treatment increase the risk of meniscal tear?

Department of Orthopaedic Surgery, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA.
Arthroscopy The Journal of Arthroscopic and Related Surgery (impact factor: 3.02). 18(9):955-9. pp.955-9
Source: PubMed

ABSTRACT To evaluate the incidence of associated injuries and meniscal tears in children and adolescents with anterior cruciate ligament (ACL) tears, we performed a retrospective review of patients, age 14 and younger, who were treated surgically at our institution.
Retrospective review.
We reviewed 39 patients (30 girls, 9 boys) with an average age of 13.6 years (range, 10 to 14 years) who underwent surgical treatment of the ACL; 24 right knees and 15 left knees were treated. Of the injuries treated, 24 occurred by a twisting mechanism, 10 were the result of contact, and 5 occurred from hyperextension. Thirty-five injuries occurred during sports activities, and 2 were sustained in motor vehicle accidents. The mean duration from injury to operative treatment was 101 days (range, 7 to 696 days). Injuries were classified as acute (n = 17) if surgery was performed within 6 weeks of injury and chronic (n = 22) if surgery was performed after 6 weeks from injury. Relationships between medial and lateral meniscal injuries and the time from injury to surgery were analyzed, and the 2 groups, acute and chronic, were compared. Finally, the patterns of meniscal injury were compared.
Twenty-six patients had associated injuries (10 medial meniscal tears, 15 lateral meniscal tears, 3 medial collateral ligament tears, and 1 fractured femur). The association between medial meniscal tears and time from injury to surgery was highly statistically significant (P =.0223). There was no statistical significance between the incidence of lateral meniscal tears and time. Medial meniscal tears were more common in the chronic group (36%) than in the acute group (11%), whereas lateral meniscal tears were found with equal frequency. Medial meniscal tears that required surgical treatment (either partial excision or repair) were more common in the chronic group, and lateral meniscal tear patterns were equally distributed.
Evidence from this study supports the contention that associated injuries are common in young individuals with ACL tears. Furthermore, the data also show that a delay in surgical treatment was associated with a higher incidence of medial meniscal tears.

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Keywords

10 medial meniscal tears
 
15 lateral meniscal tears
 
2 groups
 
3 medial collateral ligament tears
 
39 patients
 
6 weeks
 
ACL tears
 
anterior cruciate ligament
 
associated injuries
 
higher incidence
 
lateral meniscal injuries
 
lateral meniscal tears
 
medial meniscal tears
 
meniscal injury
 
meniscal tears
 
motor vehicle accidents
 
partial excision
 
Retrospective review
 
statistical significance
 
young individuals