Anterior cruciate ligament reconstruction in skeletally immature patients
| Autor: | U. G. Longo, Vincenzo Candela, N. Mannering, Mauro Ciuffreda, Giuseppe Salvatore, Carlo Casciaro, Vincenzo Denaro |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Knee Joint Anterior cruciate ligament reconstruction Anterior cruciate ligament medicine.medical_treatment MEDLINE Statistical difference Transplantation Autologous Tendons Arthroscopy 03 medical and health sciences 0302 clinical medicine Open physis Lysholm score Humans Medicine Orthopedics and Sports Medicine 030222 orthopedics Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries Recovery of Function 030229 sport sciences Surgery Treatment Outcome medicine.anatomical_structure Systematic review Physical therapy Growth plates business |
| Zdroj: | The Bone & Joint Journal. :1053-1060 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.99b8.bjj-2016-1150.r1 |
| Popis: | Aims Different methods of anterior cruciate ligament (ACL) reconstruction have been described for skeletally immature patients before closure of the growth plates. However, the outcome and complications following this treatment remain unclear. The aim of this systematic review was to analyse the outcome and complications of different techniques which may be used for reconstruction of the ACL in these patients. Materials and Methods We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This involved a comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase and Google Scholar databases using the following combinations of keywords, “knee”, “anterior cruciate ligament”, “reconstruction”, “injury”, “children”, “adolescent”, “skeletally immature”, “open physis” and “surgery”. Results A total of 53 studies met the inclusion criteria and were included for analysis. The overall rate of disturbance of growth after ACL reconstruction was 2.6%, with no statistical difference between transphyseal and physeal-sparing techniques. Physeal-sparing techniques had a lower rate of post-operative complications compared with transphyseal techniques (p = 0.0045). Outcomes assessed were Lysholm score, International Knee Documentation Committee (IKDC) score, the IKDC grade, the Tegner score and the KT-1000. Both techniques had similar clinical outcomes. Conclusions This review reveals low rates of disturbance of growth after ACL reconstruction in skeletally immature patients. Although limited, the available evidence did not support any particular surgical technique when considering disturbance of growth or clinical outcome. Further randomised controlled trials are needed to investigate the efficacy of differing surgical techniques on outcomes in skeletally immature patients. Cite this article: Bone Joint J 2017;99-B:1053–60. |
| Databáze: | OpenAIRE |
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