Intraarticular stabilization following anterior cruciate ligament injury in children and adolescents

Nikolaou, Pantelis; Kalliakmanis, Alkiviadis; Bousgas, Dimitrios; Zourntos, Sarantos

doi:10.1007/s00167-010-1375-y

Cited by 57 publications

(34 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An accurate understanding of the athlete' s physical maturity by determining skeletal age and Tanner stage helps to identify which treatment is best for a specific patient. 73,86,87,[92][93][94][95][96][97][98] The most common method of measuring the patient' s skeletal age is to compare an anteroposterior radiograph of the patient' s left hand and wrist to an age-specific radiograph in the Greulich and Pyle atlas. 94 Tanner stage can be determined by self-assessment, which has been shown to be valid and reliable.…”

Section: Treatmentmentioning

confidence: 99%

Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention

LaBella¹,

Hennrikus²,

et al. 2014

View full text Add to dashboard Cite

The number of anterior cruciate ligament (ACL) injuries reported in athletes younger than 18 years has increased over the past 2 decades. Reasons for the increasing ACL injury rate include the growing number of children and adolescents participating in organized sports, intensive sports training at an earlier age, and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. ACL injury rates are low in young children and increase sharply during puberty, especially for girls, who have higher rates of noncontact ACL injuries than boys do in similar sports. Intrinsic risk factors for ACL injury include higher BMI, subtalar joint overpronation, generalized ligamentous laxity, and decreased neuromuscular control of knee motion. ACL injuries often require surgery and/or many months of rehabilitation and substantial time lost from school and sports participation. Unfortunately, regardless of treatment, athletes with ACL injuries are up to 10 times more likely to develop degenerative arthritis of the knee. Safe and effective surgical techniques for children and adolescents continue to evolve. Neuromuscular training can reduce risk of ACL injury in adolescent girls. This report outlines the current state of knowledge on epidemiology, diagnosis, treatment, and prevention of ACL injuries in children and adolescents.

show abstract

Section: Treatmentmentioning

confidence: 99%

Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention

LaBella¹,

Hennrikus²,

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A number of series' report transphyseal ACL reconstructions using a variety of grafts and fixation devices with good outcomes in pediatric patients and little risk of growth disturbance [8,10,[50][51][52][53][54][55], [56•], [57], [58•]. Aronowitz et al [50] used Achilles tendon allograft with 9-10 mm tunnels in patients with a skeletal age of at least 14.…”

Section: Transphyseal Techniquesmentioning

confidence: 99%

“…Five patients were Tanner stage I or II, 21 were Tanner stage III or IV and there were no reported growth or angular deformities. Nikolaou et al [57] reported the results of 94 transphyseal hamstring reconstructions in patients followed to skeletal maturity. Of these patients 66 were Tanner stage I or II.…”

Section: Transphyseal Techniquesmentioning

confidence: 99%

Pediatric anterior cruciate ligament reconstruction

McConkey

Bonasia

Amendola³

2011

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

An increasing number of anterior cruciate ligament (ACL) injuries are seen in children now than in the past due to increased sports participation. The natural history of ACL deficient knees in active individuals, particularly in children is poor. Surgical management of ACL deficiency in children is complex due to the potential risk of injury to the physis and growth disturbance. Delaying ACL reconstruction until maturity is possible but risks instability episodes and intra-articular damage. Surgical options include physeal-sparing, partial transphyseal and complete transphyseal procedures. This article reviews the management of ACL injured skeletally immature patients including the functional outcome and complications of contemporary surgical techniques.

show abstract

“…Studies in adult patients [7,8,24,39] and in pediatric patients [12,28,32] have shown an increased incidence of medial meniscal tears with delayed ACL reconstruction. Although the treatment of ACL tears in skeletally immature patients remains controversial [33], the risk of physeal injury and resulting growth disturbance from ACL repair to a patient with open physes is now thought to be small [15,22], and many centers (including our institution) opt for prompt reconstruction before skeletal maturity [9,16,20,25,31,34,40].…”

Section: Introductionmentioning

confidence: 99%

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Guenther

Swami

Dhillon

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Delay of as much as 5 months between ACL injury and surgery is known to be associated with increased risk of a medial meniscal tear, but the risk of additional meniscal tear progression with a longer delay to surgery is unclear. Questions/purposes We determined the (1) times of injury, MRI, and surgery in adolescents with ACL tears, and whether (2) timing of surgery, or (3) initial integrity of the meniscus seen on MR images predicted development of meniscal tears. Methods We reviewed 112 adolescents who were 15 ± 1 years old (mean ± SD) (range, 11-16 years) with a torn ACL. These patients underwent surgical repair from 2005 to 2011 in a Canadian city. We compared dates of injury, MRI, and surgery. A pediatric and musculoskeletal fellowship-trained radiologist reread the MR images, and meniscal injuries were graded according to severity. This was compared with surgical findings described in the operative report. Results Time after injury to MRI and surgery averaged 77 days (range, 1-377 days) and 342 days (range, 42-1637 days), respectively. Patients with new or worsened medial meniscal tears had waited longer for surgery (445 versus 290 days; p = 0.002). Bucket handle medial meniscal tears were more common in patients with surgery more than 1 year after injury than others (15 of 34 versus 14 of 75; p = 0.013). A medial meniscal tear observed on MR images was a significant covariate for a torn meniscus at surgery (relative risk, 5.7; 95% CI, 2.8-11.6). Medial meniscal survival continued to decline sharply greater than 1 year after injury. Conclusions Medial meniscal tears, especially bucket handle tears, increased steadily in frequency more than 1 year after ACL injury. Timely ACL reconstruction may be warranted to reduce the risk of further medial meniscal damage even in patients whose original injury occurred more than 1 year before. Level of Evidence Level IV, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.

show abstract

Intraarticular stabilization following anterior cruciate ligament injury in children and adolescents

Abstract: IV.

Cited by 57 publications

References 48 publications

Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention

Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention

Pediatric anterior cruciate ligament reconstruction

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Contact Info

Product

Resources

About