{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:01:51Z","timestamp":1789844511677,"version":"4.0.1"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>In the context of increasing intensive year\u2010round training amongst youth athletes, the incidence of paediatric anterior cruciate ligament (ACL) reconstruction has risen markedly. There is a growing interest in minimising surgical complications for these patients. Although the literature has demonstrated an association between operative time and complications for ACL reconstruction in adults, this has not been explored in younger patients. The primary purpose of this study was to determine whether operative time is a risk factor for complications following ACL reconstruction in skeletally immature patients. Secondary aims included identifying the most common types of complications in this cohort and identifying which of these complications were associated with increased operative time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective, multicenter surgeon\u2010driven registry was reviewed to identify skeletally immature patients who underwent primary isolated ACL reconstruction, with a minimum 8\u2010month follow\u2010up. Demographics, surgical characteristics, operative time and complications were recorded. Continuous variables were compared via an independent\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test or analysis of variance, and categorical variables were compared via Chi\u2010squared or Fisher's exact tests. Comparisons were deemed to be statistically significant using a threshold of\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05. Multiple logistic regression analysis was performed to control for baseline characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 719 patients were included with a mean follow\u2010up of 17.6\u2009\u00b1\u20098.6 months (range 8\u201330 months), 483 (67.2%) were male. Mean age was 13.3\u2009\u00b1\u20091.9 years. Mean operative time was 115.1\u2009\u00b1\u200944.2\u2009min. The complication rate for the cohort was 15.3%. After adjusting for baseline characteristics, increased operative time remained an independent risk factor for developing a complication (OR\u2009=\u20091.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Specifically, increased operative time was an independent risk factor for surgical site infection (OR\u2009=\u20091.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) and arthrofibrosis (OR\u2009=\u20091.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increased operative time was found to be an independent risk factor for complications following ACL reconstruction for skeletally immature patients. Specifically, operative time was associated with surgical site infection and arthrofibrosis. Future efforts to improve operative efficiency are warranted to improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70759","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:16:36Z","timestamp":1779192996000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Increased operative time is an independent risk factor for surgical complications following isolated anterior cruciate ligament reconstruction in skeletally immature patients"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5368-8097","authenticated-orcid":false,"given":"Rishi","family":"Sinha","sequence":"first","affiliation":[{"name":"Carilion Clinic Department of Orthopaedic Surgery Roanoke Virginia USA"},{"name":"Virginia Tech Carilion School of Medicine Roanoke Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Van","family":"Pelt","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children Dallas Texas USA"},{"name":"University of Texas Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Hospital for Special Surgery New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G.","family":"Shea","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Stanford University Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily L.","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Children's National Hospital Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Saper","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine Seattle Children's Hospital Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery Rady Children's Hospital San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore J.","family":"Ganley","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia, Sports Medicine and Performance Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip L.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children Dallas Texas USA"},{"name":"University of Texas Southwestern Medical 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