The effects of timing of pediatric knee ligament surgery on short-term academic performance in school-aged athletes.
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.
Trentacosta
Natasha E
NE
Department of Orthopaedic Surgery, Center for Adolescent and Pediatric Sports Medicine, New York-Presbyterian Medical Center, Columbia University, New York, New York10032, USA.
Vitale
Mark A
MA
Ahmad
Christopher S
CS
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