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.
Si
Articolo in rivista - Articolo scientifico
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Anterior cruciate ligament; Arthroscopic fixation; Open physes; Paediatric;
English
3689
3696
8
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].
Turati, M; Rigamonti, L; Zanchi, N; Piatti, M; Gaddi, D; Gorla, M; Omeljaniuk, R; Courvoisier, A; Bigoni, M
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/298951
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