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AOSSM: Delayed ACL Repair Risky in Children

Delayed reconstruction independently associated with increased risk of further knee damage

MONDAY, July 13 (HealthDay News) -- The risks associated with delaying reconstruction of an anterior cruciate ligament (ACL) tear may outweigh the benefits in skeletally immature young people, according to research presented at the annual meeting of the American Orthopaedic Society for Sports Medicine, held July 9 to 12 in Keystone, Colo.

J. Todd R. Lawrence, M.D., of the Children's Hospital of Philadelphia, and colleagues retrospectively reviewed the records of 69 patients (70 knees) aged 14 years and younger who underwent ACL reconstruction between 1991 and 2005. Of these, 29 knees (41 percent) underwent ACL reconstruction after greater than a 12-week delay. These patients were advised to wear a custom ACL brace. The remaining patients underwent earlier reconstruction.

The researchers found that delayed ACL reconstruction was independently associated with a four-fold increased risk of medial meniscus tears, an 11-fold increased risk for lateral compartment chondral injuries, and a three-fold increased risk for patellotrochlear chondral injuries. The authors further note that delayed reconstruction was also significantly associated with other injuries and instability.

"The risk of inducing a growth disturbance with early reconstruction of a torn ACL must be balanced against the risk of further knee damage by delaying treatment until closer to skeletal maturity," a co-author acknowledged in a statement. "Our results highlight and help quantify the risk associated with delaying ACL reconstruction in young athletes and the need for continued injury prevention efforts."

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