Unusual case of a surgically treated ACL tear in a 4-year-old patient

Astur, Diego Costa; Castro, Saulo; Bernardes, Adilio de Paula; Cohen, Moisés

doi:10.1136/bcr-2015-210817

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…＃References 1, 4, 6, 7, 11 –21, 23 –27, 29 –34, 39, 40, 42 –52, 54, 56 –59, 61, 63, 66, 67, 72, 74 –78, 80, 81, 83 –85, 87, 89, 91 –93, 98, 99, 101, 102.…”

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confidence: 99%

Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Zebis

Warming

Pedersen

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:The incidence of anterior cruciate ligament (ACL) injuries in children is increasing. However, no standardized core set of outcome measures exists for evaluating pediatric ACL injuries.Purpose:To perform a scoping review of the literature to identify patient-reported outcome measures (PROMs) and objective outcome measures used to evaluate pediatric patients after ACL injury and to classify these in accordance with the International Classification of Functioning, Disability, and Health (ICF) domains.Study Design:Systematic review; Level of evidence, 4.Methods:The literature was systematically searched with the PubMed, EMBASE, CINAHL, and PEDro databases. The inclusion criteria were Danish, Norwegian, Swedish, German, or English language; publication between 2010 and 2018; pediatric ACL injury (patients ≤15 years old); and outcome measures. The selected papers were screened for title, abstract, and full text in accordance with predefined inclusion and exclusion criteria.Results:A total of 68 papers (4286 patients; mean ± SD age, 12.2 ± 2.3 years) were included. Nineteen PROMs and 11 objective outcome measures were identified. The most frequently reported PROMs were the International Knee Documentation Committee (IKDC) Subjective Knee Form (51% of studies), Lysholm scoring scale (46% of studies) and Tegner activity rating scale (37% of studies). Additionally, return to sport was reported in 41% of studies. The most frequent objective measures were knee laxity (76% of studies), growth disturbances (69% of studies), range of motion (41% of studies), and muscle strength (21% of studies). With respect to the ICF domains, the IKDC covered all 3 ICF health domains, the Lysholm score covered the Body Structure and Function and the Activity Limitation domains, while the Tegner score covered the Participation Restriction domain. Objectively measured knee joint laxity, range of motion, and muscle strength covered 1 domain (Body Structure and Function).Conclusion:Pediatric patients with ACL injury were mainly evaluated subjectively with the IKDC and objectively by knee joint laxity. No consensus exists in the evaluation of children after ACL injury. The majority of applied outcome measures are developed for adults. To cover the ICF health domains, future research needs to consider reliable and valid outcome measures relevant for pediatric patients with ACL injury.

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“…＃References 1, 4, 6, 7, 11 –21, 23 –27, 29 –34, 39, 40, 42 –52, 54, 56 –59, 61, 63, 66, 67, 72, 74 –78, 80, 81, 83 –85, 87, 89, 91 –93, 98, 99, 101, 102.…”

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confidence: 99%

Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Zebis

Warming

Pedersen

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…Complications resulting from physis drilling such as abnormal bone growth or angular deformities are rarely mentioned and probably underreported in the literature [1, 8, 12, 16, 23, 27, 32]. However, it seems that most patients who did not undergo reconstruction, or wait for skeletal maturity to do surgery, often have associated lesions such as meniscus or chondral injury and consequently will undergo more complex procedures and worse results are expected [2–4, 20].…”

Section: Introductionmentioning

confidence: 99%

Intraarticular hamstring graft diameter decreases with continuing knee growth after ACL reconstruction with open physes

Astur

Arliani

Debieux

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…References 1, 2, 4 -9, 11, 13, 14, 17-22, 24-29, 31, 33, 34, 38-50, 52-54, 56, 58-61, 63-67, 69-74, 76-78, 81-86, 88, 89, 91...…”

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confidence: 99%

Assessment of Skeletal Maturity and Postoperative Growth Disturbance After Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients: A Systematic Review

et al. 2021

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Background: Growth disturbance is an uncommon but potentially serious complication after anterior cruciate ligament (ACL) reconstruction in skeletally immature patients. Purpose: To describe how the pediatric ACL literature has assessed preoperative skeletal maturity and the amount of growth remaining and to comprehensively review the incidence, reporting, and monitoring of postoperative growth disturbance. Study Design: Systematic review; Level of evidence, 4. Methods: This review included studies reporting original research of clinical outcomes of skeletally immature patients after ACL reconstruction. Patient characteristics, surgical techniques, preoperative assessments of skeletal maturity or growth remaining, and postoperative assessments of growth disturbances were extracted. Results: A total of 100 studies met inclusion criteria. All studies reported chronological age, and 28 studies (28%) assessed skeletal age. A total of 44 studies (44%) used Tanner staging, and 12 studies (12%) obtained standing hip-to-ankle radiographs preoperatively. In total, 42 patients (2.1%) demonstrated a leg length discrepancy (LLD) >10 mm postoperatively, including 9 patients (0.5%) with LLD >20 mm; furthermore, 11 patients (0.6%) with LLD underwent growth modulation. Shortening was the most common deformity overall, but overgrowth was reported more frequently in patients who had undergone all-epiphyseal techniques. Most LLDs involved the femur (83%). A total of 26 patients (1.3%) demonstrated a postoperative angular deformity ≥5°, and 9 of these patients underwent growth modulation. The most common deformities were femoral valgus (41%), tibial recurvatum (33%), and tibial varus (22%). Although standing hip-to-ankle radiographs were the most common radiographic assessment of growth disturbance, most studies inadequately reported the clinical and radiographic methods of assessment for growth disturbance. Additionally, only 35% of studies explicitly followed patients to skeletal maturity. Conclusion: This systematic review described significant variability in the reporting and monitoring of growth-related complications after ACL reconstruction in skeletally immature patients. The incidence of LLD and angular deformity appeared to be low, but the quality of research was not comprehensive enough for accurate assessment. Registration: CRD42019136059 (PROSPERO)

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Unusual case of a surgically treated ACL tear in a 4-year-old patient

Cited by 5 publications

References 18 publications

Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

Intraarticular hamstring graft diameter decreases with continuing knee growth after ACL reconstruction with open physes

Assessment of Skeletal Maturity and Postoperative Growth Disturbance After Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients: A Systematic Review

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