Nonanatomic Anterior Cruciate Ligament Reconstruction With Double-Stranded Semitendinosus Grafts in Children With Open Physes Minimum 15-Year Follow-up

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art_DEMANGE_Nonanatomic_Anterior_Cruciate_Ligament_Reconstruction_With_DoubleStranded_Semitendinosus_2014.PDF (1.06 MB)
Citações na Scopus
39
Tipo de produção
article
Data de publicação
2014
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS INC
Autores
Citação
AMERICAN JOURNAL OF SPORTS MEDICINE, v.42, n.12, p.2926-2932, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Nonanatomic anterior cruciate ligament (ACL) reconstruction (ACLR) with double-stranded semitendinosus grafts in children with open physes has been described as a successful surgical technique in short-term follow-up clinical reports. Purpose: To evaluate the clinical outcomes of nonanatomic ACLR in children with open physes and a minimum of 15 years' follow-up. Study Design: Case series; Level of evidence, 4. Methods: Twelve patients with an average age of 10.7 years (range, 8.3-12.4 years) underwent ACLR between 1991 and 1998. All patients were classified as Tanner development stage 2 or lower. The surgical technique involved transphyseal tibial tunnel drilling and over-the-top (OTT) femoral fixation using a double-stranded graft for all patients. Clinical outcomes were evaluated in terms of the manual Lachman test, pivot-shift test, return to sports activity, and International Knee Documentation Committee (IKDC) score at the end of growth and at a minimum 15-year follow-up (range, 15-22 years). Results: No clinically significant growth disturbance was observed. Ten patients had a grade A IKDC score, and 2 patients had a grade B IKDC score at the end of growth. There was no progression of laxity or modification of knee stability with growth. Three patients (25%) had ACL reruptures during sports activities after growth plate closure. All patients with reruptured ACLs underwent additional reconstructive surgery. Conclusion: Anterior cruciate ligament reconstruction using the OTT technique in the femur and the transphyseal technique in the tibia produces good results with regard to growth plate closure but a high failure rate in adulthood.
Palavras-chave
anterior cruciate ligament, open physes, children, knee instability
URI
https://observatorio.fm.usp.br/handle/OPI/9024
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MOT
Artigos e Materiais de Revistas Científicas - LIM/41