Prospective Methodology Results in Higher Rates of Reported Complications Following Pediatric ACL Reconstruction

Area of Science:

• Orthopedic Surgery
• Pediatric Sports Medicine
• Surgical Outcomes Research

Background:

• Pediatric anterior cruciate ligament reconstruction (ACLR) incidence has risen significantly.
• Limited research exists on prospective, surgeon-reported pediatric ACLR complications.
• This study addresses this gap by analyzing a large, multicenter, prospective registry.

Purpose of the Study:

• To determine complication incidence within 8 months after pediatric ACLR using a prospective registry.
• To compare complication rates between prospective (SCORE) and non-prospective (ABOS) databases.
• To evaluate if surgeon experience (≤5 vs. >5 years) affects pediatric ACLR complication rates.

Main Methods:

• Review of complication data from the prospective Sports Cohort Outcomes Registry (SCORE) and the non-prospective American Board of Orthopaedic Surgeons (ABOS) database.
• Analysis of pediatric ACLR cases (SCORE: ≤18 years, 2018-2025; ABOS: ≤19 years, 2000-2021).
• Statistical comparison using chi-squared and Fisher's exact tests, with significance set at P<0.05.

Main Results:

• No significant difference in overall complication rates between SCORE (11.6%) and ABOS (11.1%) databases.
• Significant differences observed in specific complications like stiffness, reoperation, wound-healing delay, pain, nerve palsy, readmission, and deep vein thrombosis between the two databases.
• No significant differences in complication rates were found based on surgeon experience (≤5 vs. >5 years).

Conclusions:

• This study offers the first comprehensive list of pediatric ACLR complications from a prospective cohort.
• Prospective data collection may yield more accurate rates for reoperation and surgical complications (pain, stiffness, wound-healing delay).
• Complication rates after pediatric ACLR are comparable between early-career and experienced surgeons.