Pediatrics fare better with this ACL technique
Pediatrics fare better with this ACL technique
A new study demonstrates the superiority of a specific technique to perform anterior cruciate ligament (ACL) reconstruction in children.
In recent years, the number of ACL surgeries in pediatric athletes has skyrocketed. The study shows that a technique called the All-Inside, All-Epiphyseal ACL Reconstruction (AE) provides great knee stability and effectively controls joint stress. The study was conducted by researchers at Hospital for Special Surgery in New York City. It was presented at the recent annual meeting of the American Orthopaedic Society for Sports Medicine.
"The AE technique is not available except in a few select centers around the country including HSS," said Frank Cordasco, MD, surgical director of the Ambulatory Surgery Center and member of the Sports Medicine and Shoulder Service at HSS. "We believe the AE should be the preferred procedure for ACL reconstruction in the skeletally immature."
Twenty years ago, few children or adolescents presented at doctors' offices with ACL injuries. Today, these injuries are common because children and young adolescents are participating in sports earlier in life and at a higher level of competition. In the study, researchers, including Cordasco and HSS pediatric orthopedic surgeon Daniel Green, MD, compared two ACL reconstruction techniques for children that minimize contact with the growth plate: the AE technique and the over-the-top reconstruction (OT). In the OT, surgeons slide a graft through a hole drilled into the shinbone, but the graft is then attached to the back of the thighbone. The OT requires an open incision and does not mimic the natural ACL footprint. While other studies have compared joint stability (kinematics) of the two procedures, this is the first to study contact stresses.
In the AE, surgeons mimic the adult surgery, but the ligament is attached only to the epiphysis and does not cross into the growth plate. The AE is performed arthroscopically and mimics the natural ACL footprint.
The researchers found that the AE and OT performed similarly, but the AE performed better when the knee was at 15 degrees, which is commonly experienced by individuals running down a field.
A new study demonstrates the superiority of a specific technique to perform anterior cruciate ligament (ACL) reconstruction in children.Subscribe Now for Access
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