Correlation of Meniscal and Articular Cartilage Injuries in XXXX and Adolescents With Timing of Anterior Cruciate Ligament Reconstruction.

@entity1 @entity1844 @entity130
BACKGROUND: In pediatric @entity1 , anterior cruciate ligament (ACL) reconstruction is controversial; however, delaying surgery until skeletal maturity is complete may increase the risk of secondary meniscal and articular @entity1844 . PURPOSE: To assess the risk of meniscal and @entity130 with delay of ACL reconstruction. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Records were reviewed in @entity1 younger than 17 years (median age, 14 years) who had ACL reconstruction. @entity1 were consecutively enrolled and assigned to 1 of 3 surgical groups based on timing of surgery: acute (<6 weeks after surgery), subacute (6-12 weeks), or chronic (>3 months). The type and grade of @entity130 was documented according to the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine (ISAKOS) meniscal classification criteria. International Cartilage Repair Society (ICRS) criteria were used to document location and grade of @entity130 . Associations between @entity1 characteristics and @entity130 were tested using rank sum and chi-square tests. Regression analyses were conducted to model incidence and severity of lateral and medial meniscal tears. There were 130 @entity1 who had 135 ACL reconstructions between the years of 2000 and 2012. RESULTS: Sixty-two @entity130 were treated acutely, 37 were subacute, and 36 were chronic. @entity130 (n = 112) included 70 lateral and 42 medial tears. Time to surgery had bivariate association with lateral and medial meniscal tears (P = .016 and .007, respectively). Independent risk factors for incidence of lateral meniscal tears were younger age (P = .028) and return to sports activities before surgery (P = .007). @entity1 with 1 episode of instability had 3-fold higher odds of higher grade lateral meniscal tear (95% CI, 1.30-7.60). Compared with acute reconstruction, subacute and chronic reconstruction @entity1 had 1.45 and 2.82 times higher odds, respectively, of lateral meniscal tear severity (P = .12). Independent risk factors for incidence of medial meniscal tears were female sex (P = .03), older age (P = .01), and any episode of instability (P = .01). Adjusted odds ratio for medial meniscal tear was 4.7 for an instability episode (vs no episode; P = .01). Adjusted odds ratio for increased severity of medial meniscal tears included any instability episode, 5.6 (P < .01); playing sports before reconstruction, 15.2 (P < .01); and time to surgery greater than 3 months, 4.3 (P = .046). Seventeen @entity1 had 23 @entity130 . The risk factors for @entity130 included increased time to surgery (P = .005) and any instability episode (P = .001). For increased grade of @entity130 , risk factors were time to surgery (P  <= .001) and any instability episode (P = .003). CONCLUSION: Delayed ACL reconstruction increased the risks of secondary meniscal and @entity130 in this population of pediatric @entity1 .
