Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination Database

Background: Pediatric anterior cruciate ligament reconstructions (ACLR) have increased dramatically in recent years. However, a comprehensive list of short-term complications related to this procedure has yet to be reported. This study aimed to report complication rates in pediatric ACLR using submi...

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Main Authors: Dane R.G. Lind, BA, Meagan J. Sabatino, MSL, Virginia C. Clark, BS, Robert L. Van Pelt, MPH, Curtis D. Vandenberg, MD, Jennifer J. Beck, MD, Andrew T. Pennock, MD, Aristides I. Cruz, Jr., MD, MBA, Theodore J. Ganley, MD, Kevin G. Shea, MD, Philip L. Wilson, MD, Henry B. Ellis, MD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of the Pediatric Orthopaedic Society of North America
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Online Access:http://www.sciencedirect.com/science/article/pii/S2768276525000227
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author Dane R.G. Lind, BA
Meagan J. Sabatino, MSL
Virginia C. Clark, BS
Robert L. Van Pelt, MPH
Curtis D. Vandenberg, MD
Jennifer J. Beck, MD
Andrew T. Pennock, MD
Aristides I. Cruz, Jr., MD, MBA
Theodore J. Ganley, MD
Kevin G. Shea, MD
Philip L. Wilson, MD
Henry B. Ellis, MD
author_facet Dane R.G. Lind, BA
Meagan J. Sabatino, MSL
Virginia C. Clark, BS
Robert L. Van Pelt, MPH
Curtis D. Vandenberg, MD
Jennifer J. Beck, MD
Andrew T. Pennock, MD
Aristides I. Cruz, Jr., MD, MBA
Theodore J. Ganley, MD
Kevin G. Shea, MD
Philip L. Wilson, MD
Henry B. Ellis, MD
author_sort Dane R.G. Lind, BA
collection DOAJ
description Background: Pediatric anterior cruciate ligament reconstructions (ACLR) have increased dramatically in recent years. However, a comprehensive list of short-term complications related to this procedure has yet to be reported. This study aimed to report complication rates in pediatric ACLR using submissions to the American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination. A secondary goal was to assess the relationship of complications with patient sex, geographic region of surgery, surgical volume, and surgeon fellowship training. Methods: A query was submitted to the ABOS Part II Oral Examination Case List Database for all ACLR performed in patients younger than 19 years between 2000 and 2021. Surgeon fellowship training, geographic region of surgery, and patient demographics were included, along with medical, surgical, and anesthetic complications, reoperation, and readmission. Statistic comparisons used chi-square tests for categorical variables with significance set at P < 0.05. Results: Surgical complications were the most common type of complication, present in 10.1% of pediatric ACLR. Stiffness (3.6%) and infection (1.5%) were the most prevalent surgical complications. Females had higher rates of overall complications than males (11.9% vs. 10.4%, P = 0.010). Females also had higher rates of surgical complications (10.7%–9.5%, P = 0.019) -- specifically stiffness (5.0%–2.2%, P < 0.001). However, males had higher rates of infection (1.8% vs. 1.3%, P = 0.047). Geographic analyses showed higher infection rates in Hawaii and Alaska and lower surgical complication rates in the Northwest region. Procedures completed by surgeons with a fellowship training other than Sports Medicine and/or Pediatric Orthopaedics had lower rates of overall complications (8.9%, P < 0.001) and surgical complications (8.3%, P < 0.001). Conclusion: This study establishes that female pediatric and adolescent patients are at an increased risk for complications following ACLR. Arthrofibrosis was more than twice as common in females than in males. Geographic region and fellowship training may be associated with complications in this population. Study design: Cross-Sectional Study Key Concepts: (1) Complications following ACL reconstruction may be associated with geographic region and fellowship training. (2) Females present with more short-term complications following ACL reconstruction. (3) There was a higher reported infection rate overall for surgeons in their board collection period than infection rates in the literature, with males having an overall higher infection rate than females. (4) Arthrofibrosis is more than twice as common in females than males following ACL reconstruction. Level of Evidence: III
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spelling doaj-art-0359a9ee80f642f1b727a29324c91e412025-08-20T02:57:05ZengElsevierJournal of the Pediatric Orthopaedic Society of North America2768-27652025-05-011110017810.1016/j.jposna.2025.100178Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination DatabaseDane R.G. Lind, BA0Meagan J. Sabatino, MSL1Virginia C. Clark, BS2Robert L. Van Pelt, MPH3Curtis D. Vandenberg, MD4Jennifer J. Beck, MD5Andrew T. Pennock, MD6Aristides I. Cruz, Jr., MD, MBA7Theodore J. Ganley, MD8Kevin G. Shea, MD9Philip L. Wilson, MD10Henry B. Ellis, MD11Steadman Philippon Research Institute, Vail, CO, USAUMass Chan Medical School, Worcester, MA, USAScottish Rite for Children Orthopaedic and Sports Medicine Center, Frisco, TX, USAScottish Rite for Children Orthopaedic and Sports Medicine Center, Frisco, TX, USAChildren's Hospital Colorado, Aurora, CO, USABoulder Medical Center, Boulder, CO, USAPediatric Orthopaedics &amp; Scoliosis Center, Rady Children's Hospital, San Diego, CA, USADepartment of Orthopedics &amp; Sports Medicine, Boston Children's Hospital, Boston, MA, USAChildren's Hospital of Philadelphia, Philadelphia, PA, USAStanford University School of Medicine, Department of Orthopaedic Surgery, Stanford, CA, USAScottish Rite for Children Orthopaedic and Sports Medicine Center, Frisco, TX, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA; Children's Medical Center, Dallas, TX, USAScottish Rite for Children Orthopaedic and Sports Medicine Center, Frisco, TX, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA; Children's Medical Center, Dallas, TX, USA; Corresponding author: Scottish Rite for Children, 5700 Dallas Parkway, Frisco, TX 75034, USA.Background: Pediatric anterior cruciate ligament reconstructions (ACLR) have increased dramatically in recent years. However, a comprehensive list of short-term complications related to this procedure has yet to be reported. This study aimed to report complication rates in pediatric ACLR using submissions to the American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination. A secondary goal was to assess the relationship of complications with patient sex, geographic region of surgery, surgical volume, and surgeon fellowship training. Methods: A query was submitted to the ABOS Part II Oral Examination Case List Database for all ACLR performed in patients younger than 19 years between 2000 and 2021. Surgeon fellowship training, geographic region of surgery, and patient demographics were included, along with medical, surgical, and anesthetic complications, reoperation, and readmission. Statistic comparisons used chi-square tests for categorical variables with significance set at P < 0.05. Results: Surgical complications were the most common type of complication, present in 10.1% of pediatric ACLR. Stiffness (3.6%) and infection (1.5%) were the most prevalent surgical complications. Females had higher rates of overall complications than males (11.9% vs. 10.4%, P = 0.010). Females also had higher rates of surgical complications (10.7%–9.5%, P = 0.019) -- specifically stiffness (5.0%–2.2%, P < 0.001). However, males had higher rates of infection (1.8% vs. 1.3%, P = 0.047). Geographic analyses showed higher infection rates in Hawaii and Alaska and lower surgical complication rates in the Northwest region. Procedures completed by surgeons with a fellowship training other than Sports Medicine and/or Pediatric Orthopaedics had lower rates of overall complications (8.9%, P < 0.001) and surgical complications (8.3%, P < 0.001). Conclusion: This study establishes that female pediatric and adolescent patients are at an increased risk for complications following ACLR. Arthrofibrosis was more than twice as common in females than in males. Geographic region and fellowship training may be associated with complications in this population. Study design: Cross-Sectional Study Key Concepts: (1) Complications following ACL reconstruction may be associated with geographic region and fellowship training. (2) Females present with more short-term complications following ACL reconstruction. (3) There was a higher reported infection rate overall for surgeons in their board collection period than infection rates in the literature, with males having an overall higher infection rate than females. (4) Arthrofibrosis is more than twice as common in females than males following ACL reconstruction. Level of Evidence: IIIhttp://www.sciencedirect.com/science/article/pii/S2768276525000227Pediatric sports medicineACLR complicationsABOSFellowship training
spellingShingle Dane R.G. Lind, BA
Meagan J. Sabatino, MSL
Virginia C. Clark, BS
Robert L. Van Pelt, MPH
Curtis D. Vandenberg, MD
Jennifer J. Beck, MD
Andrew T. Pennock, MD
Aristides I. Cruz, Jr., MD, MBA
Theodore J. Ganley, MD
Kevin G. Shea, MD
Philip L. Wilson, MD
Henry B. Ellis, MD
Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination Database
Journal of the Pediatric Orthopaedic Society of North America
Pediatric sports medicine
ACLR complications
ABOS
Fellowship training
title Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination Database
title_full Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination Database
title_fullStr Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination Database
title_full_unstemmed Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination Database
title_short Trends in Complications Following Pediatric Anterior Cruciate Ligament Reconstruction as Reported to the American Board of Orthopaedic Surgery Part II Oral Examination Database
title_sort trends in complications following pediatric anterior cruciate ligament reconstruction as reported to the american board of orthopaedic surgery part ii oral examination database
topic Pediatric sports medicine
ACLR complications
ABOS
Fellowship training
url http://www.sciencedirect.com/science/article/pii/S2768276525000227
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