Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (12): 1943-1948.doi: 10.3969/j.issn.2095-4344.1027

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Early versus delayed reconstruction of anterior cruciate ligament injuries in children and adolescents is associated with the risks of meniscus and articular cartilage injury: a meta-analysis  

Gu Xiaodong1, 2, Zhao Ruipeng1, 2, Che Xianda1, 2, Li Pengcui1, 2, Wei Xiaochun1, 2   

  1. 1Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; 2Shanxi Provincial Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi Province, China
  • Online:2019-04-28 Published:2019-04-28
  • Contact: Wei Xiaochun, MD, Chief physician, Professor, Doctoral supervisor, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; Shanxi Provincial Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi Province, China
  • About author:Gu Xiaodong, Doctoral candidate, Attending physician, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; Shanxi Provincial Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan 030001, Shanxi Province, China
  • Supported by:

    the National International Science and Technology Cooperation Project, No. 2015DFA33050 (to WXC); the National Natural Science Foundation of China for the Youth, No. 81601949 (to LPC); the Osteoarthritis Biological Sample Resource Sharing Service Platform Construction Project of Shanxi Province, No. 201705D121010 (to LPC)

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Abstract:

BACKGROUND: Surgical treatment is mostly advocated in children and adolescents with anterior cruciate ligament injury, but the impact of surgical timing and different surgical timing on the risk of secondary meniscus and cartilage injury is still controversial.

OBJECTIVE: To evaluate the effects of early or delayed anterior cruciate ligament reconstruction on the risk of secondary meniscus and articular cartilage injury in children and adolescents.
METHODS: A computer-based online search was conducted in Medline, Embase, Cochrane Library, WanFang, and CNKI databases until March 2018. The articles about anterior cruciate ligament rupture in children or adolescents (< 19 years old) undergoing ligamentous reconstruction, and injuries of meniscus and knee cartilage at different operation times were collected in accordance with the inclusion and exclusion criteria. Meta-analysis was performed using Review Manager 5.3 software.
RESULTS AND CONCLUSION: Five articles involving 849 patients were included. Meta-analysis showed that early anterior cruciate ligament reconstruction after anterior cruciate ligament rupture in children and adolescents could significantly reduce the risk of medial meniscus injury (OR=0.40, 95%CI 0.25-0.67, P=0.000 4). At the same time, the risk of secondary lateral meniscus injury in early ligament reconstruction was reduced (OR=0.70, 95%CI 0.53-0.93, P=0.01). In terms of articular cartilage injury, compared with delayed reconstruction, early reconstruction could reduce the incidence of injuries of femoral condyle cartilage (OR=0.25, 95%CI 0.12-0.53, P=0.000 3), tibial plateau cartilage (OR=0.41, 95%CI 0.25-0.67, P=0.000 4) and patellofemoral joint cartilage (OR=0.35, 95%CI 0.16-0.77, P=0.009). In summary, for children and adolescents with anterior cruciate ligament rupture, early anterior cruciate ligament reconstruction can reduce the incidence of secondary medial and lateral meniscus, femoral condyle cartilage, tibial plateau cartilage and patellofemoral cartilage injuries. 

Key words: Anterior Cruciate Ligament, Adolescent, Child, Meta-Analysis

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