The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing Technique
Purpose: To evaluate radiological tibial and femoral length and axis growth disturbances, as well as clinical outcome in skeletal immature anterior cruciate ligament reconstruction (ACLR) patients treated with a femoral growth plate-sparing ACLR technique. Methods: Skeletally immature patients who u...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X2300144X |
| _version_ | 1797389398427303936 |
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| author | Peter Ziegler Faunø, M.D. Jannie Bøge Steinmeier Larsen, M.H.Sc. Mette Mølby Nielsen, M.H.Sc. Michel Hellfritzsch, M.D. Torsten Grønbech Nielsen, B.Sc. Martin Lind, Ph.D. |
| author_facet | Peter Ziegler Faunø, M.D. Jannie Bøge Steinmeier Larsen, M.H.Sc. Mette Mølby Nielsen, M.H.Sc. Michel Hellfritzsch, M.D. Torsten Grønbech Nielsen, B.Sc. Martin Lind, Ph.D. |
| author_sort | Peter Ziegler Faunø, M.D. |
| collection | DOAJ |
| description | Purpose: To evaluate radiological tibial and femoral length and axis growth disturbances, as well as clinical outcome in skeletal immature anterior cruciate ligament reconstruction (ACLR) patients treated with a femoral growth plate-sparing ACLR technique. Methods: Skeletally immature patients who underwent operation between 2013 to 2019 with ALCR using the femoral growth plate-sparing technique were investigated with follow-up after growth plate closure. The inclusion criteria were isolated ACL rupture in patients with open physis in the distal femur and proximal tibia seen at plain radiography. The minimum follow-up time was 29 months. Patients were evaluated with full extremity radiographs measuring limb length discrepancy and coronal knee alignment compared to contralateral leg, as well as clinical evaluation with Rolimeter measurements and the Knee Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee subjective knee form (IKDC), and Tegner Activity Scale scores. Results: Sixty-five patients were examined with radiography, and 52 patients were assessed with clinical examination. The mean follow-up time was 68 (range, 29-148) months. No limb-length discrepancy (−0.65 mm [confidence interval {CI}, −2.21 to 0.92]) or angular deformity at tibia (−0.25° [CI, −0.78° to 0.28°]) was found. There was a small but statistically significant different angular deformity at the distal femur compared to the contralateral leg (−1.51° [CI, −2.31 to −0.72]) at follow-up. The side-to-side difference in knee laxity at follow-up was 2.4 mm. At follow-up the KOOS Sport, KOOS Quality of Life (QoL), IKDC, and Tegner scores were 80, 75, 86, and 5, respectively. Sixty-seven percent of the patients met the Patient Acceptable Symptom State, and 52% reported results exceeding the KOOS Sport MCID Level and 69% the KOOS QoL level. Conclusions: Femoral physis-sparing ALCR is associated with a low risk of alignment and length disturbances. The technique provides otherwise good subjective clinical outcome and knee stability. Level of Evidence: Level IV, therapeutic case series. |
| first_indexed | 2024-03-08T22:56:20Z |
| format | Article |
| id | doaj.art-3a11cc8f79cb43fa9afb980d24d026d6 |
| institution | Directory Open Access Journal |
| issn | 2666-061X |
| language | English |
| last_indexed | 2024-03-08T22:56:20Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj.art-3a11cc8f79cb43fa9afb980d24d026d62023-12-16T06:09:00ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2023-12-0156100793The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing TechniquePeter Ziegler Faunø, M.D.0Jannie Bøge Steinmeier Larsen, M.H.Sc.1Mette Mølby Nielsen, M.H.Sc.2Michel Hellfritzsch, M.D.3Torsten Grønbech Nielsen, B.Sc.4Martin Lind, Ph.D.5Address correspondence to Peter Ziegler Faunø, M.D., Department of Sports Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark.; Department of Sports Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Sports Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Sports Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Sports Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Sports Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Sports Medicine, Aarhus University Hospital, Aarhus, DenmarkPurpose: To evaluate radiological tibial and femoral length and axis growth disturbances, as well as clinical outcome in skeletal immature anterior cruciate ligament reconstruction (ACLR) patients treated with a femoral growth plate-sparing ACLR technique. Methods: Skeletally immature patients who underwent operation between 2013 to 2019 with ALCR using the femoral growth plate-sparing technique were investigated with follow-up after growth plate closure. The inclusion criteria were isolated ACL rupture in patients with open physis in the distal femur and proximal tibia seen at plain radiography. The minimum follow-up time was 29 months. Patients were evaluated with full extremity radiographs measuring limb length discrepancy and coronal knee alignment compared to contralateral leg, as well as clinical evaluation with Rolimeter measurements and the Knee Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee subjective knee form (IKDC), and Tegner Activity Scale scores. Results: Sixty-five patients were examined with radiography, and 52 patients were assessed with clinical examination. The mean follow-up time was 68 (range, 29-148) months. No limb-length discrepancy (−0.65 mm [confidence interval {CI}, −2.21 to 0.92]) or angular deformity at tibia (−0.25° [CI, −0.78° to 0.28°]) was found. There was a small but statistically significant different angular deformity at the distal femur compared to the contralateral leg (−1.51° [CI, −2.31 to −0.72]) at follow-up. The side-to-side difference in knee laxity at follow-up was 2.4 mm. At follow-up the KOOS Sport, KOOS Quality of Life (QoL), IKDC, and Tegner scores were 80, 75, 86, and 5, respectively. Sixty-seven percent of the patients met the Patient Acceptable Symptom State, and 52% reported results exceeding the KOOS Sport MCID Level and 69% the KOOS QoL level. Conclusions: Femoral physis-sparing ALCR is associated with a low risk of alignment and length disturbances. The technique provides otherwise good subjective clinical outcome and knee stability. Level of Evidence: Level IV, therapeutic case series.http://www.sciencedirect.com/science/article/pii/S2666061X2300144X |
| spellingShingle | Peter Ziegler Faunø, M.D. Jannie Bøge Steinmeier Larsen, M.H.Sc. Mette Mølby Nielsen, M.H.Sc. Michel Hellfritzsch, M.D. Torsten Grønbech Nielsen, B.Sc. Martin Lind, Ph.D. The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing Technique Arthroscopy, Sports Medicine, and Rehabilitation |
| title | The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing Technique |
| title_full | The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing Technique |
| title_fullStr | The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing Technique |
| title_full_unstemmed | The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing Technique |
| title_short | The Risk of Growth Disturbance Is Low After Pediatric Anterior Cruciate Ligament Reconstruction With a Femoral Growth Plate Sparing Technique |
| title_sort | risk of growth disturbance is low after pediatric anterior cruciate ligament reconstruction with a femoral growth plate sparing technique |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X2300144X |
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