Treatment of ACL Tears in the Skeletally Immature Patient

Joseph, Sheeba M.; Huleatt, Joel; Vogel-Abernathie, Laura A; Pace, J. Lee

doi:10.1097/jsa.0000000000000216

Cited by 7 publications

(10 citation statements)

References 36 publications

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“…Skeletally mature patients or those with little growth remaining usually undergo traditional adult-type reconstruction with PT, QT, or HT grafts [ 3 , 27 ]. Previous studies have indicated good clinical results for IT band ACLR [ 6 , 10 ]. This study adds quantitative data showing faster restoration of knee kinematics and kinetics compared with other graft types.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Innovations in surgical technique, especially for younger, highly active patients, have improved outcomes and made ACLR the preferred treatment option even at younger ages [ 6 ]. ACLR in skeletally immature patients requires extra care due to the risk of growth disturbance or development of angular deformity if open growth plates are damaged [ 6 , 7 , 8 ]. Many ACLR surgical techniques have been described which allow for continued growth in patients with open physes, including techniques that avoid crossing the growth plate [ 6 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…ACLR in skeletally immature patients requires extra care due to the risk of growth disturbance or development of angular deformity if open growth plates are damaged [ 6 , 7 , 8 ]. Many ACLR surgical techniques have been described which allow for continued growth in patients with open physes, including techniques that avoid crossing the growth plate [ 6 , 9 ]. These include ACLR using iliotibial (IT) band autograft which has produced excellent functional outcomes in skeletally immature, prepubescent children [ 6 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Many ACLR surgical techniques have been described which allow for continued growth in patients with open physes, including techniques that avoid crossing the growth plate [ 6 , 9 ]. These include ACLR using iliotibial (IT) band autograft which has produced excellent functional outcomes in skeletally immature, prepubescent children [ 6 , 10 ]. Technical advantages of the IT band autograft ACLR technique include avoidance of any tunnel reaming, along with this technique resulting in combined intraarticular and extraarticular ligamentous reconstruction [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

Wren

Beltran

Katzel

et al. 2021

IJERPH

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Iliotibial band autograft is an increasingly popular option for pediatric anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare recovery of knee extensor mechanism function among pediatric patients who underwent ACLR using iliotibial band (IT), hamstring tendon (HT), quadriceps tendon (QT), and patellar tendon (PT) autografts. One hundred forty-five pediatric athletes (76 female; age 15.0, range 7–21 years) with recent (3–18 months) unilateral ACLR performed drop-jump landing and 45° cutting with 3D motion capture. Knee extensor mechanism function (maximum knee flexion angle, maximum internal knee extensor moment, energy absorption at knee) during the loading phase (foot contact to peak knee flexion) was compared among graft types (20 IT, 29 HT, 39 QT, 57 PT) and sides (ACLR or contralateral) using linear mixed models with sex, age, and time since surgery as covariates. Overall, knee flexion was significantly lower on the operated vs. contralateral side for HT, QT, and PT during both tasks (p < 0.03). All graft types exhibited lower knee extensor moments and energy absorption on the operated side during both movements (p ≤ 0.001). Kinetic asymmetry was significantly lower for IT compared with QT and PT during both movements (p ≤ 0.005), and similar patterns were observed for HT vs. QT and PT (p ≤ 0.07). Asymmetry was similar between IT and HT and between QT and PT. This study found that knee extensor mechanism function recovers fastest in pediatric ACLR patients with IT autografts, followed by HT, in comparison to QT and PT, suggesting that IT is a viable option for returning young athletes to play after ACLR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

Wren

Beltran

Katzel

et al. 2021

IJERPH

View full text Add to dashboard Cite

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Anterior Cruciate Ligament Injury

Callender

2021

Common Pediatric Knee Injuries

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The incidence of anterior cruciate ligament injury in youth and male soccer athletes: an evaluation of 17,108 players over two consecutive seasons with an age-based sub-analysis

Astur

Margato

Zobiole

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate the incidence of anterior cruciate ligament (ACL) injuries in male athletes from professional soccer clubs over two consecutive seasons (2018-2019) with a sub-analysis based on age category: under-13 (U-13), under-15 (U-15), under-17 (U-17), and under-20 (U-20) years. Methods A total of 17,108 young male soccer players were retrospectively reviewed from sixty-three professional clubs in the four highest Brazilian soccer divisions. Data regarding the number of athletes and the number of ACL injuries conirmed by magnetic resonance imaging (MRI) exams in the 2018 and 2019 seasons were collected. Incidence of ACL injury were compared by season, age category (under-13; under-15; under 17; and under-20), demographic region, and club division. Results Clubs from all regions of Brazil participated in the study. A total of 336 primary ACL injuries were diagnosed over the two seasons (8,167 athletes during the 2018 season and 8,941 athletes during the 2019 season) among all athletes, which corresponds to 2% of the included athletes. There were 11 cases (0.3%) in the under-13, 53 cases (1.3%) in the under-15, 107 cases (2.5%) in the under-17, and 165 cases (3.8%) in the under-20 age category. There was a higher incidence of ACL injury in the older age groups (p < 0.001). Conclusion A total of 336 ACL injuries were identiied in 17,108 youth soccer players from 63 professional clubs with an overall incidence of 2% over 2 seasons of competition. ACL injury rate ranged from 0.3% to 3.8% and was higher in the older and more competitive club divisions. Level of evidence IV.

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Treatment of ACL Tears in the Skeletally Immature Patient

Cited by 7 publications

References 36 publications

Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

Anterior Cruciate Ligament Injury

The incidence of anterior cruciate ligament injury in youth and male soccer athletes: an evaluation of 17,108 players over two consecutive seasons with an age-based sub-analysis

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