Paediatric anterior cruciate ligament tears: Management and growth disturbances. A survey of EPOS and POSNA membership

Accadbled, Franck; Gracia, Gauthier; Laumonerie, Pierre; Thévenin-Lemoine, Camille; Heyworth, Benton E.; Kocher, Mininder S.

doi:10.1302/1863-2548.13.190074

Cited by 19 publications

(18 citation statements)

References 35 publications

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“…Despite such limitations, the survey had an excellent response rate of 46.3% higher than most other surveys. [13][14][15][16][17] In conclusion, surgeon experience, type of fracture, treatment modality, and pins configuration were indicated as the main factors influencing the outcome of SHFs. EPOS members agreed on the treatment modality of Gartland's type II and III SHFs, patient positioning, and timing of hardware removal.…”

Section: Discussionmentioning

confidence: 88%

“…The 2020 EPOS SHFs questionnaire received the highest response rate (46.3%) among EPOS surveys; in fact, most of the previous questionnaires received a variable response rate, between 23% and 43%. 13 – 17 Concerning the previously published SHFs surveys from other scientific societies, they reported limited evidence, focused on specific fracture patterns only, did not detail the post-operative protocol, and in some cases were limited to a restricted cohort of a nation cohort. 2 , 7 , 18 , 19 The 2020 EPOS SHFs survey provided data on the management and follow-up of SHFs from more than 20 countries.…”

Section: Discussionmentioning

confidence: 99%

“…Despite such limitations, the survey had an excellent response rate of 46.3% higher than most other surveys. 13 – 17 …”

Section: Discussionmentioning

confidence: 99%

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Current trends in the treatment of supracondylar fractures of the humerus in children: Results of a survey of the members of European Paediatric Orthopaedic Society

Pavone

Vescio

Accadbled

et al. 2022

Journal of Children's Orthopaedics

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Purpose: The purpose of this study was to evaluate the current trends in the treatment of supracondylar humerus fractures as well as the preferred post-operative follow-up protocol among members of the European Paediatric Orthopaedic Society. Methods: The survey was composed by four main domains and 26 items: (1) surgeon information (3 items); (2) treatment (8 items); (3) post-operative treatment (3 items); and (4) factors influencing the outcome (12 items). All active members of European Paediatric Orthopaedic Society were invited by email to answer an electronic questionnaire. Results: The survey was submitted to 397 European Paediatric Orthopaedic Society active members; 184 members answered (46.3%) the questionnaire. Among respondents, 64.1% declared >10 years of experience and 55.4% declared to treat >20 supracondylar humerus fractures per year. Closed reduction, percutaneous pinning, and supine position were the preferred treatment option for Gartland type II and III supracondylar humerus fractures by 79.9%, 95.5%, and 84.8% of respondents, respectively. Supracondylar humerus fractures are treated within 24 h from trauma by 33.2% of respondents. Pins are removed 4 weeks from index procedure by 58.2% of respondents. Fracture type (72.3%), surgeon experience, and (71.2%) are of “crucial importance” for expected outcome of supracondylar humerus fractures treatment. Conclusion: Surgeon experience, type of fracture, treatment modality, and pins configuration were considered the main factors potentially influencing the outcome of supracondylar humerus fractures. European Paediatric Orthopaedic Society members agreed on the treatment modality of Gartland type II and III supracondylar humerus fractures, patient positioning, and timing of hardware removal. Other important issues such as timing of surgery, pins configuration, surgical approach, and post-operative protocol are still debated. Level of evidence: level II.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Current trends in the treatment of supracondylar fractures of the humerus in children: Results of a survey of the members of European Paediatric Orthopaedic Society

Pavone

Vescio

Accadbled

et al. 2022

Journal of Children's Orthopaedics

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“…The SITOP 2020 FFF survey had a response rate of 44.3% that can be considered as appropriate to outline the current diagnosis, management and treatment options among SITOP members; the response rate is higher than in previous surveys [5][6][7][8][9]11].…”

Section: Discussionmentioning

confidence: 99%

Results of the Italian Pediatric Orthopedics Society juvenile flexible flatfoot survey: diagnosis and treatment options

Pavone

Vescio

Andreacchio

et al. 2021

Journal of Pediatric Orthopaedics B

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The objectives of this study were to collect and analyze current diagnosis and treatment options of symptomatic flexible flatfoot (FFF), as well as to identify treatment expectations, among the members of the Italian Pediatric Orthopedics Society (SITOP). Diagnosis and treatment preferences were recorded according to a web-based survey. The survey was divided into six main sections:(1) general clinical parameters; (2) foot aspects; (3) X-ray angles (or lines); (4) expectations; (5) standard clinical assessment; (6) treatment options. One hundred and ten out of 248 SITOP members answered to the questionnaire. Age (85.5%), pain at the level of the plantar arch or fascia (61.8%), fatigue (59.1%) were the clinical parameters of crucial importance. Heel valgus (85.4%), flexibility (61.8%) and forefoot supination (47.3%) were identified as the most important foot aspects. Ninety-two responders (83.6%) identified the 'improved ability to walk longer without symptoms or discomfort' as the principal treatment expectation. Pain evaluated through the visual analog scale (VAS) was considered crucial in 31.8% of cases. All respondents confirmed they also treat patients with FFF surgically; in particular, 97.3% of SITOP affiliates declare to perform arthroereisis followed by lateral column lengthening (29.1%) and medializing calcaneal osteotomy (9.1%). Although in this survey heterogeneous findings for diagnosis and treatment of patients with symptomatic FFF within SITOP members were found, a large preference for age, heel valgus, flexibility as clinical aspects and parameters, as well as nonoperative treatment and arthroereisis, was reported.

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“…It is one of the main procedures performed in elective orthopedic surgery. The use of the semitendinosus (ST) as a single tendon graft is growing, 1 therefore sparing the gracilis.…”

Section: Introductionmentioning

confidence: 99%

Does harvesting of the semitendinosus tendon really spare the gracilis in pediatric anterior cruciate ligament reconstruction?

Testory

Cavaignac

Vial

et al. 2022

Journal of Children's Orthopaedics

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Purpose: The use of isolated semitendinosus tendon for Anterior Cruciate Ligament Reconstruction bears several advantages and is popular worldwide. It assumes that the gracilis tendon is spared. The aim of the study was to measure the surface area of the gracilis tendon in children who had undergone arthroscopic reconstruction of the anterior cruciate ligament using a semitendinosus tendon graft. Our hypothesis was that the gracilis tendon may be unintentionally and iatrogenically sectioned due to the anatomical proximity and the small size of the patients. Methods: Fifty patients who had undergone a magnetic resonance imaging preoperatively and postoperatively at 1 year from the surgery and who had been operated between January 2017 and March 2019 were included in this prospective series. The surface area of the gracilis tendon was measured on fat-saturated T2-weighted axial views at the widest point of the medial epicondyle of the femur. Age, sex, body weight, and height were documented. Results: One hundred magnetic resonance imaging of 50 knees were reviewed, from 34 boys (68%) and 16 girls (32%). The mean age was 14.5 years (10–18). The gracilis was visualized in all cases at 1 year postoperatively. The average tendinous surface area of the gracilis before the surgical procedure was 7.13 mm2 versus 8.73 mm2 at 1 year, representing an increase of 1.6 mm2 (p = 0.0003). Conclusions: This study demonstrated that harvesting of the semitendinosus for the purpose of Anterior Cruciate Ligament Reconstruction was a safe technique that preserves the gracilis. Level of evidence: III.

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Paediatric anterior cruciate ligament tears: Management and growth disturbances. A survey of EPOS and POSNA membership

Cited by 19 publications

References 35 publications

Current trends in the treatment of supracondylar fractures of the humerus in children: Results of a survey of the members of European Paediatric Orthopaedic Society

Current trends in the treatment of supracondylar fractures of the humerus in children: Results of a survey of the members of European Paediatric Orthopaedic Society

Results of the Italian Pediatric Orthopedics Society juvenile flexible flatfoot survey: diagnosis and treatment options

Does harvesting of the semitendinosus tendon really spare the gracilis in pediatric anterior cruciate ligament reconstruction?

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