ACL Reconstruction Delay in Pediatric and Adolescent Patient
Researchers sought to investigate the relationship between the time from an anterior cruciate ligament (ACL) tear to the surgical procedure and meniscal tears in the pediatric and adolescent population.

Patients who were less than 18 years of age and had undergone an ACL reconstruction were identified in a retrospective, multicenter cohort. The primary outcomes were arthroscopically confirmed medial meniscal or lateral meniscal tears specifically and, in general, if any meniscal tear was present (medial and/or lateral). A multivariable Poisson regression model was used to determine whether the time from the injury to the surgical procedure was a risk factor for subsequent meniscal injury, after controlling for sex, age, and body mass index (BMI).

--In this study, 546 patients were identified. For each week that the surgical procedure was delayed, there was a 2% increased risk of a medial meniscal tear.

--The weekly increase in risk of a medial meniscal injury was significant for male patients (ARR, 1.03), but not for female patients (ARR, 1.00), even though the effect modification was not significant.

--Obese male patients had a 77.9% increased risk of medial meniscal tear for each 10-week delay.

--The use of crutches was associated with a decreased risk of medial meniscal tears.

Finally, after an ACL tear, the risk of meniscal damage is high in juvenile and teenage patients. For male patients, a 3 % weekly increase in the probability of medial meniscal injury was associated with a delay from the injury to the surgical treatment, but not for female patients. Obese male patients were at a higher risk of medial meniscal damage as a result of the surgical operation being delayed.