{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:02:00Z","timestamp":1779235320813,"version":"3.51.4"},"reference-count":47,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cruciate ligament reconstruction (ACLR) in pediatric patients is becoming increasingly common. There is growing yet limited literature on the risk factors for revision in this demographic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To (1) determine the rate of pediatric revision ACLR in a nationally representative sample, (2) ascertain the associated patient- and injury-specific risk factors for revision ACLR, and (3) examine the differences in the rate and risks of revision ACLR between pediatric and adult patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case-control study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The PearlDiver patient record database was used to identify adult patients (age \u226520 years) and pediatric patients (age &lt;20 years) who underwent primary ACLR between 2010 and 2015. At 5 years postoperatively, the risk of revision ACLR was compared between the adult and pediatric groups. ACLR to the contralateral side was also compared. Multivariate logistic regression was used to determine the significant risk factors for revision ACLR and the overall reoperation rates in pediatric and adult patients; from these risk factors, an algorithm was developed to predict the risk of revision ACLR in pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Included were 2055 pediatric patients, 1778 adult patients aged 20 to 29 years, and 1646 adult patients aged 30 to 39 years who underwent ACLR. At 5 years postoperatively, pediatric patients faced a higher risk of revision surgery when compared with adults (18.0 % vs 9.2% [adults 20-29 years] and 7.1% [adults 30-39 years]; P &lt; .0001), with significantly decreased survivorship of the index ACLR ( P &lt; .0001; log-rank test). Pediatric patients were also at higher risk of undergoing contralateral ACLR as compared with adults (5.8% vs 1.6% [adults 20-29 years] and 1.9% [adults 30-39 years]; P &lt; .0001). Among the pediatric cohort, boys (odds ratio [OR], 0.78; 95% CI, 0.63-0.96; P = .0204) and patients &gt;14 years old (OR, 0.62; 95% CI, 0.45-0.86; P = .0035) had a decreased risk of overall reoperation; patients undergoing concurrent meniscal repair (OR, 1.84; 95% CI, 1.43-2.38; P &lt; .0001) or meniscectomy (OR, 2.20; 95% CI, 1.72-2.82; P &lt; .0001) had an increased risk of revision surgery. According to the risk algorithm, the highest probability for revision ACLR was in girls &lt;15 years old with concomitant meniscal and medial collateral ligament injury (36% risk of revision).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>As compared with adults, pediatric patients had an increased likelihood of revision ACLR, contralateral ACLR, and meniscal reoperation within 5 years of an index ACLR. Families of pediatric patients\u2014especially female patients, younger patients, and those with concomitant medial collateral ligament and meniscal injuries\u2014should be counseled on such risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2325967121991165","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T05:18:28Z","timestamp":1616563108000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Risk Factors for Failure After Anterior Cruciate Ligament Reconstruction in a Pediatric Population: A Prediction Algorithm"],"prefix":"10.1177","volume":"9","author":[{"given":"Nicholas J.","family":"Lemme","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel S.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke","family":"Barrow","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan H.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Aristides I.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"bibr1-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511415655"},{"key":"bibr2-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-1877"},{"key":"bibr3-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4757-8"},{"key":"bibr4-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518819217"},{"key":"bibr5-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000606"},{"key":"bibr6-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2011.10.005"},{"key":"bibr7-2325967121991165","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-478-15"},{"key":"bibr8-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001055"},{"key":"bibr9-2325967121991165","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-17-00294"},{"key":"bibr10-2325967121991165","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.00758"},{"key":"bibr11-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001367"},{"key":"bibr12-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513518412"},{"key":"bibr13-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513496548"},{"key":"bibr14-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518756349"},{"key":"bibr15-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3364-z"},{"key":"bibr16-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0741-0"},{"key":"bibr17-2325967121991165","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000831"},{"key":"bibr18-2325967121991165","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/0471722146.ch5","author":"Hosmer DW","year":"2000","journal-title":"Applied Logistic Regression. 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