{"doi":"10.1177/23259671251313754","title":"Incidence and Risk Factors for Posttraumatic Osteoarthritis After Primary ACL Reconstruction in Pediatric Patients: A National Database Study","abstract":"<jats:sec>\n                    <jats:title>Background:</jats:title>\n                    <jats:p>The development of posttraumatic osteoarthritis (PTOA) of the knee after anterior cruciate ligament (ACL) reconstruction (ACLR) leads to additional morbidity in adults.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:</jats:title>\n                    <jats:p>To determine the 5-year incidence of and risk factors for PTOA diagnoses after primary ACLR in pediatric 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>A United States-based insurance database was used to identify patients aged ≤16 years who underwent primary ACLR from 2010 to 2019 and had at least 5 years of follow-up data. Patients with multiligament knee injuries, tibial eminence avulsion fractures, congenital/syndromic ACL absence syndrome, juvenile idiopathic arthritis, previous knee osteoarthritis or PTOA diagnoses, or previous knee injuries/surgeries were excluded. Demographic factors and concomitant meniscal and cartilage procedures at the time of primary ACLR were recorded. Delayed ACLR was defined as ≥3 months between initial ACL injury diagnosis and ACLR. We also recorded the presence of subsequent motion restoration reoperations, including lysis of adhesions and/or manipulation under anesthesia, after primary ACLR but before PTOA diagnosis. Risk factors for PTOA were evaluated using multivariable logistic regression.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:</jats:title>\n                    <jats:p>Included were 16,935 patients (mean age at surgery, 15.1 ± 1.2 years; 62% women). PTOA was diagnosed in 267 patients (1.6%) within 5 years after ACLR; 148 of these patients (55.4%) were diagnosed within 2 years after ACLR. Independent risk factors associated with PTOA diagnosis included subsequent motion restoration procedures (odds ratio [OR], 5.03 [95% CI, 3.31-8.25]; P &lt; .001), age ≥12 years at the time of ACLR (OR, 4.82 [95% CI, 1.54-29.20]; P = .027), delayed ACLR (OR, 1.87 [95% CI, 1.43-2.43]; P &lt; .001), obesity (OR, 1.40 [95% CI, 1.01-1.94]; P = .046), and male sex (OR, 1.36 [95% CI, 1.06-1.74]; P = .015). Performing concomitant partial meniscectomy, meniscus repair, and cartilage restoration at the time of ACLR was not significantly associated with PTOA.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:</jats:title>\n                    <jats:p>The incidence of PTOA diagnoses was low within 5 years after primary ACLR in patients ≤16 years old with no subsequent cartilage, meniscus, and/or revision ligament procedures. The need for subsequent motion restoration procedures, age ≥12 years at the time of ACLR, delayed ACLR, obesity, and male sex were significant risk factors associated with a PTOA diagnosis.</jats:p>\n                  </jats:sec>","journal":"Orthopaedic Journal of Sports Medicine","year":2025,"id":624389,"datarank":0.32958368660043297,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"self_citation_contribution":0.32958368660043297,"citation_network_contribution":0.0,"self_endowment_contribution":0.32958368660043297,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1041852,"name":"Michael J. Gouzoulis","orcid":"0000-0002-9318-3314","position":1,"is_corresponding":false},{"id":369520,"name":"Kyle N. Kunze","orcid":"0000-0002-0363-3482","position":2,"is_corresponding":false},{"id":1614106,"name":"Christopher M. LaPrade","orcid":"0000-0002-2381-3704","position":3,"is_corresponding":false},{"id":498821,"name":"Jonathan N. Grauer","orcid":"0000-0002-2626-7278","position":4,"is_corresponding":false},{"id":366772,"name":"Timothy E. Hewett","orcid":"0000-0001-9729-7573","position":5,"is_corresponding":false},{"id":286519,"name":"Jorge Chahla","orcid":"0000-0002-9194-1150","position":6,"is_corresponding":false},{"id":1614108,"name":"Andrew E. Jimenez","orcid":"0000-0002-7979-6536","position":7,"is_corresponding":false},{"id":1614109,"name":"Scott D. McKay","orcid":"0000-0002-0490-0220","position":8,"is_corresponding":false},{"id":1444535,"name":"Peter D. Fabricant","orcid":"0000-0002-8070-685X","position":9,"is_corresponding":false},{"id":369522,"name":"Robert F. LaPrade","orcid":"0000-0002-9823-2306","position":10,"is_corresponding":false},{"id":1313519,"name":"Corinna C. Franklin","orcid":"0000-0002-6395-0105","position":11,"is_corresponding":false},{"id":1303440,"name":"Jay Moran","orcid":"0000-0001-6247-3047","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Incidence and Risk Factors for Posttraumatic Osteoarthritis After Primary ACL Reconstruction in Pediatric Patients: A National Database Study","abstract":"<jats:sec>\n                    <jats:title>Background:</jats:title>\n                    <jats:p>The development of posttraumatic osteoarthritis (PTOA) of the knee after anterior cruciate ligament (ACL) reconstruction (ACLR) leads to additional morbidity in adults.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:</jats:title>\n                    <jats:p>To determine the 5-year incidence of and risk factors for PTOA diagnoses after primary ACLR in pediatric 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>A United States-based insurance database was used to identify patients aged ≤16 years who underwent primary ACLR from 2010 to 2019 and had at least 5 years of follow-up data. Patients with multiligament knee injuries, tibial eminence avulsion fractures, congenital/syndromic ACL absence syndrome, juvenile idiopathic arthritis, previous knee osteoarthritis or PTOA diagnoses, or previous knee injuries/surgeries were excluded. Demographic factors and concomitant meniscal and cartilage procedures at the time of primary ACLR were recorded. Delayed ACLR was defined as ≥3 months between initial ACL injury diagnosis and ACLR. We also recorded the presence of subsequent motion restoration reoperations, including lysis of adhesions and/or manipulation under anesthesia, after primary ACLR but before PTOA diagnosis. Risk factors for PTOA were evaluated using multivariable logistic regression.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:</jats:title>\n                    <jats:p>Included were 16,935 patients (mean age at surgery, 15.1 ± 1.2 years; 62% women). PTOA was diagnosed in 267 patients (1.6%) within 5 years after ACLR; 148 of these patients (55.4%) were diagnosed within 2 years after ACLR. Independent risk factors associated with PTOA diagnosis included subsequent motion restoration procedures (odds ratio [OR], 5.03 [95% CI, 3.31-8.25]; P &lt; .001), age ≥12 years at the time of ACLR (OR, 4.82 [95% CI, 1.54-29.20]; P = .027), delayed ACLR (OR, 1.87 [95% CI, 1.43-2.43]; P &lt; .001), obesity (OR, 1.40 [95% CI, 1.01-1.94]; P = .046), and male sex (OR, 1.36 [95% CI, 1.06-1.74]; P = .015). Performing concomitant partial meniscectomy, meniscus repair, and cartilage restoration at the time of ACLR was not significantly associated with PTOA.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:</jats:title>\n                    <jats:p>The incidence of PTOA diagnoses was low within 5 years after primary ACLR in patients ≤16 years old with no subsequent cartilage, meniscus, and/or revision ligament procedures. The need for subsequent motion restoration procedures, age ≥12 years at the time of ACLR, delayed ACLR, obesity, and male sex were significant risk factors associated with a PTOA diagnosis.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39926589","pmcid":null,"openalex_id":"https://openalex.org/W4407208068","authors":[],"funders":[],"total_grants":0,"fwci":8.7442,"citation_percentile":0.98009032,"influential_citations":0,"citation_trend":[{"year":2025,"count":3},{"year":2026,"count":5}],"oa_status":"gold","license":"cc-by-nc-nd","oa_locations":[{"url":"https://doi.org/10.1177/23259671251313754","host_type":"journal"},{"url":"https://doi.org/10.1177/23259671251313754","host_type":"publisher"},{"url":"https://journals.sagepub.com/doi/pdf/10.1177/23259671251313754","host_type":"publisher"},{"url":"https://journals.sagepub.com/doi/full-xml/10.1177/23259671251313754","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39926589","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11806457","host_type":"repository"},{"url":"https://doaj.org/article/caa8766fd85c43e5b0f735ae79c6e4ad","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11806457/pdf/10.1177_23259671251313754.pdf","host_type":"repository"}],"fields_of_study":["Knee injuries and reconstruction techniques","Total Knee Arthroplasty Outcomes","Osteoarthritis Treatment and Mechanisms"],"mesh_terms":[],"keywords":["Medicine","Anterior cruciate ligament reconstruction","Osteoarthritis","Arthrofibrosis","Incidence (geometry)","Anterior cruciate ligament","Surgery","Avulsion","Logistic regression","Concomitant","Odds ratio","Retrospective cohort study","Range of motion","Internal medicine"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-04T03:38:55.126153Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}