Purpose: The aim of this study was to assess midterm clinical outcomes in Tanner 1–2 patients with proximal anterior cruciate ligament (ACL) tears following arthroscopic-surgical repair using an absorbable or an all-suture anchor. Methods: Fourteen (9.2 ± 2.9 years-old) of 19 skeletally immature patients reached the 2 years of clinical follow-up. Physical examinations included the Lachman test, Pivot-shift test, One-leg Hop test, Pedi-IKDC as well as Lysholm and Tegner activity scores; knee stability was measured with a KT-1000 arthrometer. Overall re-rupture rates were also evaluated in all operated patients. Results: At 2 years post-surgery, the Lysholm score was 93.6 ± 4.3 points, and the Pedi-IKDC score was 95.7 ± 0.1. All patients returned to the same sport activity level as prior to ACL lesion within 8.5 ± 2.9 months, with one exception who reported a one-point reduction in their Tegner Activity score. No leg-length discrepancies or malalignments were observed. Four patients presented grade 1 Lachman scores, and of these, three presented grade 1 (glide) score at Pivot-shift; clinical stability tests were negative for all other patients. Anterior tibial shift showed a mean side-to-side difference of 2.2 mm (range 1–3 mm). The One-leg Hop test showed lower limb symmetry (99.9% ± 9.5) with the contralateral side. Overall, 4 out of 19 patients presented a re-rupture of the ACL with a median time between surgery and re-rupture of 3.9 years (range 1–7). Conclusion: This surgical technique efficiently repairs proximal ACL tears, leading to a restoration of knee stability and a quick return to an active lifestyle, avoiding growth plate disruption. Level of evidence: IV.

Turati, M., Rigamonti, L., Zanchi, N., Piatti, M., Gaddi, D., Gorla, M., et al. (2021). An arthroscopic repair technique for proximal anterior cruciate tears in children to restore active function and avoid growth disturbances. KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY, 29(11), 3689-3696 [10.1007/s00167-020-06367-w].

An arthroscopic repair technique for proximal anterior cruciate tears in children to restore active function and avoid growth disturbances

Turati M.
;
Rigamonti L.;Zanchi N.;Piatti M.;Gaddi D.;Gorla M.;Bigoni M.
2021

Abstract

Purpose: The aim of this study was to assess midterm clinical outcomes in Tanner 1–2 patients with proximal anterior cruciate ligament (ACL) tears following arthroscopic-surgical repair using an absorbable or an all-suture anchor. Methods: Fourteen (9.2 ± 2.9 years-old) of 19 skeletally immature patients reached the 2 years of clinical follow-up. Physical examinations included the Lachman test, Pivot-shift test, One-leg Hop test, Pedi-IKDC as well as Lysholm and Tegner activity scores; knee stability was measured with a KT-1000 arthrometer. Overall re-rupture rates were also evaluated in all operated patients. Results: At 2 years post-surgery, the Lysholm score was 93.6 ± 4.3 points, and the Pedi-IKDC score was 95.7 ± 0.1. All patients returned to the same sport activity level as prior to ACL lesion within 8.5 ± 2.9 months, with one exception who reported a one-point reduction in their Tegner Activity score. No leg-length discrepancies or malalignments were observed. Four patients presented grade 1 Lachman scores, and of these, three presented grade 1 (glide) score at Pivot-shift; clinical stability tests were negative for all other patients. Anterior tibial shift showed a mean side-to-side difference of 2.2 mm (range 1–3 mm). The One-leg Hop test showed lower limb symmetry (99.9% ± 9.5) with the contralateral side. Overall, 4 out of 19 patients presented a re-rupture of the ACL with a median time between surgery and re-rupture of 3.9 years (range 1–7). Conclusion: This surgical technique efficiently repairs proximal ACL tears, leading to a restoration of knee stability and a quick return to an active lifestyle, avoiding growth plate disruption. Level of evidence: IV.
Articolo in rivista - Articolo scientifico
Anterior cruciate ligament; Arthroscopic fixation; Open physes; Paediatric;
English
2-gen-2021
2021
29
11
3689
3696
open
Turati, M., Rigamonti, L., Zanchi, N., Piatti, M., Gaddi, D., Gorla, M., et al. (2021). An arthroscopic repair technique for proximal anterior cruciate tears in children to restore active function and avoid growth disturbances. KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY, 29(11), 3689-3696 [10.1007/s00167-020-06367-w].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/298951
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