Over the top anterior cruciate ligament reconstruction in patients with open physes: a long-term follow-up study

被引:31
作者
Lanzetti, Riccardo Maria [1 ]
Pace, Valerio [2 ]
Ciompi, Alessandro [3 ]
Perugia, Dario [4 ]
Spoliti, Marco [1 ]
Falez, Francesco [3 ]
Auro, Caraffa [2 ]
机构
[1] San Camillo Forlanini Hosp, Dept Emergency & Acceptance, Orthopaed & Traumatol Unit, Cir Ne Gianicolense 87, I-00152 Rome, Italy
[2] Univ Perugia, Piazzale Gambuli, I-06100 Perugia, Italy
[3] Santo Spirito Hosp, Lungotevere Sassia 1, I-00193 Rome, Italy
[4] Univ Roma La Sapienza, Via Elio Chianesi, I-00128 Rome, Italy
关键词
ACL rupture; ACL reconstruction; Skeletally immature patients; Over the top technique; Lateral extra-articular tenodesis; SKELETALLY IMMATURE PATIENTS; ALL-INSIDE; CHILDREN; RETURN; TEARS; SPORT; ADOLESCENTS; EPIPHYSEAL; TENODESIS; INJURIES;
D O I
10.1007/s00264-020-04490-4
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Introduction Anterior cruciate ligament (ACL) rupture in skeletally immature athletes is becoming an injury with increasing incidence. Choices of treatment are still debated, including conservative management vs. various surgical techniques. The lack of long-term reports has been highlighted in the literature. Aim: To evaluate long-term results of ACL reconstructions performed in skeletally immature patients using the Over the Top technique with lateral extra-articular tenodesis. Methods Retrospective study. All surgeries performed by same surgeon. A total of 42 patients included. All patients had pre-operative radiological studies. Subjects: 30 males and 12 females. Average age: 12.5 years (range 11-14 years). Average follow-up: 96.1 months. Clinical evaluation: Pedi-IKDC, Tegner-Lysholm, KT-1000 and plain radiographs. Standardized rehabilitation protocol. Results No instability or leg length discrepancy was recorded. Average pre-operative Tegner-Lysholm and Pedi-IKDC scores were 55 and 40, respectively, with a score of 94.8 (p < 0.05) and 94.78, respectively, at final follow-up (p < 0.05). Average post-operative (1 month) Tegner-Lysholm score: 75 (range: 62-79). Median post-operative Tegner activity: 8. Mean side-to-side (KT-1000): 1.2 mm. A total of 22 patients could go back to pre-injury sport activity, with an average rehabilitation of 7.3 months. Discussion A significant number of cases were included in our structured standardized study and follow-up. Functional scores were excellent overall. Excellent results are testified by a final achievement of 22 patients going back to pre-injury sport activity, which is in keeping with the literature. Our experience exhibited a low complication rate and no metalwork failure. We correlate our results to the use of the Over the Top technique with lateral extra-articular tenodesis. Conclusion The studied procedure seems to be an excellent option and an effective, feasible and safe technique when treating ruptured ACLs in skeletally immature patients.
引用
收藏
页码:771 / 778
页数:8
相关论文
共 50 条
[31]   Rupture of the anterior cruciate ligament in children: early reconstruction with open physes or delayed reconstruction to skeletal maturity? [J].
Julien Henry ;
Franck Chotel ;
Julien Chouteau ;
Michel Henri Fessy ;
Jérôme Bérard ;
Bernard Moyen .
Knee Surgery, Sports Traumatology, Arthroscopy, 2009, 17 :748-755
[32]   Seventeen-Year Follow-up After Meniscal Repair With Concomitant Anterior Cruciate Ligament Reconstruction in a Pediatric and Adolescent Population [J].
Tagliero, Adam J. ;
Desai, Vishal S. ;
Kennedy, Nicholas I. ;
Camp, Christopher L. ;
Stuart, Michael J. ;
Levy, Bruce A. ;
Dahm, Diane L. ;
Krych, Aaron J. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2018, 46 (14) :3361-3367
[34]   Medium- to Long-Term Follow-up after Anterior Cruciate Ligament Rupture and Repair in Healing Response Technique [J].
Jorjani, J. ;
Altmann, D. ;
Auen, R. ;
Koopmann, C. ;
Lyutenski, B. ;
Wirtz, D. C. .
ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE, 2013, 151 (06) :570-579
[35]   Long-Term Follow-Up of 24.5 Years After Intra-Articular Anterior Cruciate Ligament Reconstruction With Lateral Extra-Articular Augmentation [J].
Pernin, Jerome ;
Verdonk, Peter ;
Selmi, Tarik Ait Si ;
Massin, Philippe ;
Neyret, Philippe .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2010, 38 (06) :1094-1102
[36]   Long-term follow-up after anterior cruciate ligament reconstruction using a press-fit quadriceps tendon-patellar bone autograft [J].
Barie, Alexander ;
Koepf, Michael ;
Jaber, Ayham ;
Moradi, Babak ;
Schmitt, Holger ;
Huber, Juergen ;
Streich, Nikolaus Alexander .
BMC MUSCULOSKELETAL DISORDERS, 2018, 19
[37]   Anterior cruciate ligament reconstruction with an all-epiphyseal "over-the-top" technique is safe and shows low rate of failure in skeletally immature athletes [J].
di Sarsina, Tommaso Roberti ;
Macchiarola, Luca ;
Signorelli, Cecilia ;
Grassi, Alberto ;
Raggi, Federico ;
Muccioli, Giulio Maria Marcheggiani ;
Zaffagnini, Stefano .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2019, 27 (02) :498-506
[38]   Anterior cruciate ligament recostruction with bone-patellar tendon-bone autograft in Tanner 3 stage patients with open physes [J].
Memeo, Antonio ;
Pedretti, Leopoldo ;
Miola, Francesca ;
Albisetti, Walter .
JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B, 2012, 21 (05) :415-420
[39]   Long-Term Follow-up of Skeletally Immature Patients With Physeal-Sparing Combined Extra-/Intra-articular Iliotibial Band Anterior Cruciate Ligament Reconstruction: A 3-Dimensional Motion Analysis [J].
Sugimoto, Dai ;
Whited, Amy J. ;
Brodeur, Jeff J. ;
Liotta, Elizabeth S. ;
Williams, Kathryn A. ;
Kocher, Mininder S. ;
MicheIrt, Lyle J. ;
Heyworth, Benton E. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2020, 48 (08) :1900-1906
[40]   Outcome of a Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Technique With a Minimum 2-Year Follow-up [J].
Sonnery-Cottet, Bertrand ;
Thaunat, Mathieu ;
Freychet, Benjamin ;
Pupim, Barbara H. B. ;
Murphy, Colin G. ;
Claes, Steven .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2015, 43 (07) :1598-1605