Current State of Care for Pediatric ACL Ruptures in the Netherlands: A Survey

Abstract

The management of anterior cruciate ligament (ACL) injuries in the skeletally immature patient is an area of controversy. The purpose of this survey is to inventory the current state of care for pediatric ACL injuries in the Netherlands. This survey was conveyed by e-mail among all members of the Dutch Arthroscopy Society (Nederlandse Vereniging van Arthroscopie [NVA]) and promoted on the Web site of the NVA. It was developed by the scientific committee of the NVA by a consensus meeting discussing relevant topics in pediatric ACL injuries. All members of the NVA received the survey (n = 540). A total of 158 (29%) members responded to the survey, of which 143 were completed. A total of 126 responses were analyzed after exclusion. The main finding of this survey is that 78% of the respondents tend to treat children with open physes nonoperatively, while 65% tend to treat children with closed physes operatively. The most frequently performed procedure is the transphyseal reconstruction. Many considerations were involved in choosing operative treatment. The postoperative follow-up period varies from less than 1 year (24%) until fully grown (27%). In conclusion, this survey shows that the current state of care for pediatric ACL injuries is variable and a matter of debate in the Netherlands. Although the response rate seems low, this survey provides an overview of the opinions of specialized orthopaedic surgeons in the Netherlands. The results of this survey led to the development of the national registry for pediatric ACL in the Netherlands. The level of evidence for this study is V.

Preliminary experience of an international orthopaedic registry: The ESSKA Paediatric Anterior Cruciate Ligament Initiative (PAMI) registry

“…Universitat Autònoma de Barcelona (UAB), Spain Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. 6 Value-Based Health Care, Department of Paramedical Sciences, Fontys University of Applied Sciences, Eindhoven, The Netherlands. 7 Gelenkpunkt -Sports and Joint Surgery, Innsbruck, Austria.…”

Height is a predictor of hamstring tendon length and ACL graft characteristics in adolescents

“…Anterior cruciate ligament (ACL) injury in children and adolescents is a severe injury of the knee. The ACL reconstruction technique for children and adolescents depends on skeletal maturity and is also surgeon dependent [ 1 , 2 ]. However, general principles, such as the use of a well-positioned soft-tissue autograft with an adequate size, diameter and fixation for ACL reconstruction in adults also apply for the younger patient population [ 1 , 3 ].…”

Steigerung der Evidenz zur optimalen Behandlung kindlicher VKB-Verletzungen: Die Initiative zur Erfassung von Verletzungen des vorderen Kreuzbandes bei Kindern und Jugendlichen (Paediatric Anterior Cruciate Ligament Monitoring Initiative, PAMI)

“…Dies ebenso wie potenziell verku ¨rzte Profikarrieren oder die Aufgabe des (Freizeit-)Sportes und folgende Komplikationen mit mo ¨glichen operativen Therapieansa ¨tzen stellen eine ernsthafte gesundheitliche und wirtschaftliche Belastung dar [19]. In den aktuellen Behandlungsrichtlinien fu ¨r VKB-Verletzungen bei Kindern und Jugendlichen fehlt es ha ¨ufig an wissenschaftlicher Evidenz [5,12,14], so dass fu ¨r die behandelnden A ¨rzte kein eindeutiges Rekrutierungszentren ebenso wie die Patientenzahl stetig ansteigen. Die Auswertung der Angaben aus den ersten drei Jahren des Projektes liefert bereits aussagekra ¨ftige epidemiologische Daten und erste Trends.…”