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Trends in Pediatric ACL Reconstruction: The impact of COVID-19. Journal of athletic training Kiani, S. N., Yellin, J. L., Houlihan, N. V., Talwar, D., Shea, K. G., Ganley, T. J. 2022

Abstract

CONTEXT: The number of pediatric anterior cruciate ligament reconstructions (ACLRs) occurring yearly increased almost 6-fold from 2004 to 2014. Interestingly, there are limited recent data on rates of ACL injury and reconstruction in children and adolescents, especially in the context of COVID-19.OBJECTIVE: Given the impact of the COVID-19 pandemic on youth sports seasons and the postponement of many elective surgeries, we sought to examine the changes in rates of ACLR during this period.DESIGN: Retrospective cohort study.SETTING: This study used the Pediatric Health Information System (PHIS) database to identify eligible patients at PHIS-participating hospitals nationwide from January 2016 to June 2021, with March 1, 2020 considered the "start" of the COVID-19 pandemic.PATIENTS OR OTHER PARTICIPANTS: Using CPT codes, patients 18 years old and younger who underwent ACLR surgery were identified.INTERVENTIONS: None.MAIN OUTCOME MEASURES: Patient demographics and overall rates of surgery pre- and intra-pandemic were compared. Data were analyzed using bivariate, mixed model, and time series analyses.RESULTS: A total of 24,843 ACLRs were identified during this time period. In total, 1,853 fewer surgeries were performed after March 2020 than expected given pre-pandemic trends. Examining demographics, intra-pandemic, there was an increase in the proportion of patients who identified as White and with private insurance and a decrease in the proportion who identified as Black and with public insurance. There was also a significant shift in the proportion of ACLRs by region, with increased surgeries performed in the Midwest and decreased in the Northeast. In the model adjusted for hospital-level variability, only race and insurance status remained significant.CONCLUSIONS: Based on pre-pandemic trends, there were fewer patients than projected who underwent ACLR once the pandemic began, likely due to a combination of decreased rates of injury and delayed surgery.

View details for DOI 10.4085/1062-6050-0582.21

View details for PubMedID 35271733