title: The effects of timing of pediatric knee ligament surgery on short-term academic performance in school-aged athletes.
abstract: BACKGROUND
  Orthopaedic injuries negatively affect the academic lives of children.
  
  
  OBJECTIVE
  The timing of anterior cruciate ligament (ACL) and medial patellofemoral ligament (MPFL) reconstructions affects academic performance in school-aged athletes.
  
  
  METHODS
  Cohort study; Level of evidence, 2. Methods Records of patients < or = 18 years old who underwent ACL or MPFL reconstructions from 2001-2007 were reviewed retrospectively. Subjects had been administered a unique questionnaire to evaluate school life in the immediate postoperative period as well as International Knee Documentation Committee (IDKC), Lysholm, and Kujala knee-specific questionnaires. Patients were in 1 of 3 study cohorts: group A (surgery during school year), group B (surgery during school holiday), and group C (surgery during summer break).
  
  
  RESULTS
  There were 62 subjects (53 ACL and 12 MPFL reconstructions). A higher proportion of patients in group A required being driven to school (88.5%) than groups B (63.6%) or C (64.7%) (P < .05). A lower proportion of patients in group A returned to school immediately after surgery (3.8%) than groups B (36.4%) or C (88.2%) (P < .005). Among children who had never failed a test before surgery, a higher proportion of patients in group A failed a test (36.4%) after return to school than groups B (0%) or C (0%) (P < .05). Patients in group C had higher mean Likert scores (4.5) than groups A (3.8) or B (3.7) (P = .05) in response to the question "my grades suffered in my classes." Delay in surgery was negatively correlated with IKDC, Lysholm, and Kujala questionnaire scores (P < .05).
  
  
  CONCLUSIONS
  In school-aged athletes with ligamentous knee injuries receiving operative treatment, surgery on a school day causes more academic difficulties than surgery during a holiday or summer break. Academic benefits of delaying surgery during the school year must be weighed against potentially worse outcomes encountered with prolonged surgical delay.
authors.affiliation: Department of Orthopaedic Surgery, Center for Adolescent and Pediatric Sports Medicine, New York-Presbyterian Medical Center, Columbia University, New York, New York10032, USA.
authors.forename: Natasha E
authors.initials: NE
authors.lastname: Trentacosta
authors.forename: Mark A
authors.initials: MA
authors.lastname: Vitale
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ahmad
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001265:Athletic Injuries / Q000534:rehabilitation / Q000601:surgery; D015331:Cohort Studies; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D008592:Menisci, Tibial; D019637:Orthopedic Procedures; D057071:Patellofemoral Joint / Q000601:surgery; D012189:Retrospective Studies; D013334:Students; D011795:Surveys and Questionnaires; D013997:Time Factors