title: Risk for Revision After Anterior Cruciate Ligament Reconstruction Is Higher Among Adolescents: Results From the Danish Registry of Knee Ligament Reconstruction.
abstract: BACKGROUND
  The number of children and adolescents with anterior cruciate ligament (ACL) reconstructions is increasing, and disturbing reports on high rerupture rates in this group have been noted.
  
  
  OBJECTIVE
  To describe the outcome of ACL reconstruction in children and adolescents based on data from the Danish Knee Ligament Reconstruction Registry (DKRR).
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  Data were retrieved from the DKRR, a national population-based registry. The analysis was based on a population of 14,806 ACL-reconstructed patients. The outcome was evaluated using risk of ACL revision, subjective outcome score (Knee injury and Osteoarthritis Outcome Score [KOOS]), Tegner function score, and objective knee laxity. Three age groups were defined (A, <13 years; B, 13-15 years; and C, 15-20 years) and compared with D, patients ≥20 years (adults). There were 95 patients in group A, 327 in B, 2888 in C, and 11,496 in D.
  
  
  RESULTS
  There was a significantly increased risk of revision surgery in the age groups B (6.7%) and C (4.9%) compared with the adults in group D (2.0%). Objective knee laxity did not differ between the 4 groups. Groups A, B, and C had a higher score on the combined KOOS symptoms, pain, sport, and quality of life subscales (KOOS4; 79.6, 76.6, and 73.1, respectively) compared with the adults (69.7). Group B had higher KOOS quality of life (76.6) and sports (71.1) scores than did group C (73.1 and 66.4, respectively). The Tegner activity score did not differ between the 4 groups. No impact of the use of extracortical graft fixation was detected in the youngest age group.
  
  
  CONCLUSIONS
  Study results indicated an increased risk of graft failure in patients between 13 and 20 years of age. This is in contrast to the better subjective and equal objective knee score found in the same age groups.
  
  
  CONCLUSIONS
  The new knowledge about the high revision rate among ACL-reconstructed teenagers is important for evidence-based preoperative information of ACL patients and their parents.
authors.affiliation: Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Faunø
authors.affiliation: Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Rahr-Wagner
authors.affiliation: Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Lind
keywords: ACL; adolescent; knee; national registry; reconstruction; revision