Oslo Sports Trauma Research, Norwegian School of Sports Science, Oslo, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Am J Sports Med. 2023 Sep;51(11):2891-2899. doi: 10.1177/03635465231185742. Epub 2023 Jul 27.
The incidence of pediatric and adolescent anterior cruciate ligament reconstruction (ACLR) is increasing in several countries. It is uncertain whether this trend applies to countries that traditionally prefer an initial nonoperative treatment approach whenever possible, like Norway. Nationwide, long-term patient-reported outcomes and revision rates after ACLR in the pediatric population are also lacking.
To determine the incidence of pediatric ACLR in Norway since 2005, as well as to detect trends in surgical details and describe patient-reported outcomes up to 10 years after ACLR.
Descriptive cohort study.
This study is based on prospectively collected data on girls ≤14 years and boys ≤16 years, registered in the Norwegian Knee Ligament Register at the time of their primary ACLR, between 2005 and 2021. The main outcome was the incidence of ACLR, adjusted to the corresponding population numbers for each year. The time trend was analyzed by comparing the mean of the first and last 3-year period (2005-2007 and 2019-2021). Patient-reported outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score preoperatively and at 2, 5, and 10 years postoperatively.
A total of 1476 patients (1484 cases) were included, with a mean follow-up of 8.1 years (range, 1-17). The incidence of pediatric ACLRs per 100,000 population increased from 18 to 26, which corresponds to an increase of 40% for boys and 55% for girls. Concurrent meniscal procedures increased significantly from 45% to 62%, and the proportion of meniscal repairs increased from 19% to 43% when comparing the first and last time period. The mean Knee injury and Osteoarthritis Outcome Score values for the Sport and Recreation and Quality of Life subscales were between 72 and 75 at the 2-, 5- and 10-year follow-up. The 5-year revision rate was 9.9%.
There was a major increase in incidence of pediatric ACLR in Norway during the study period. There was a shift in the approach to concomitant meniscal procedures from resection to repair, with more than a doubling of the proportion of meniscal repairs. Patient-reported outcomes revealed long-lasting reduced knee function.
在多个国家，儿童和青少年前交叉韧带重建（ACLR）的发病率正在增加。尚不确定这一趋势是否适用于挪威等传统上尽可能优先选择初始非手术治疗方法的国家。在全国范围内，儿童人群 ACLR 后的长期患者报告结局和翻修率也缺乏。
确定自 2005 年以来挪威儿童 ACLR 的发病率，并检测手术细节的趋势，并描述 ACLR 后 10 年的患者报告结局。
描述性队列研究。
本研究基于在 2005 年至 2021 年期间，在挪威膝关节韧带登记处接受初次 ACLR 的≤14 岁女孩和≤16 岁男孩的前瞻性收集数据。主要结局是 ACLR 的发病率，根据每年相应的人口数量进行调整。通过比较前 3 年（2005-2007 年和 2019-2021 年）和最后 3 年的平均值来分析时间趋势。使用膝关节损伤和骨关节炎结果评分（KOOS）在术前和术后 2、5 和 10 年进行患者报告的结局评估。
共纳入 1476 例患者（1484 例），平均随访 8.1 年（1-17 年）。每 100,000 人口的儿科 ACLR 发病率从 18 例增加到 26 例，男孩增加 40%，女孩增加 55%。同期半月板手术显著增加，从 45%增加到 62%，当比较前、后两个时间段时，半月板修复的比例从 19%增加到 43%。运动和娱乐及生活质量亚量表的 KOOS 平均值在 2、5 和 10 年随访时在 72 到 75 之间。5 年翻修率为 9.9%。
在研究期间，挪威儿科 ACLR 的发病率显著增加。同期半月板手术的处理方式从切除转为修复，半月板修复的比例增加了一倍多。患者报告的结局显示膝关节功能长期下降。
