Return to play in paediatric &amp; adolescent patients following anterior cruciate ligament reconstruction

Kilkenny, Conor J.; Hurley, Eoghan T.; Hogan, Richard E.; Moore, Thomas K.; Withers, Daniel; King, Enda; Jackson, Mark; Moran, Ray

doi:10.1016/j.knee.2022.05.013

Cited by 2 publications

(5 citation statements)

References 21 publications

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“…A total of 22 articles were identified that reported failure rates of transphyseal ACL reconstruction in children younger than 16 years [16–37]. In 16 studies (659 patients) a transtibial technique and in 6 studies (351 patients) an independent technique was used for drilling the femoral tunnel (Table 1).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of transphyseal ACL reconstruction in children and adolescents: comparing the transtibial and independent femoral tunnel drilling techniques

et al. 2023

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Purpose Aim of this systematic review was to analyze the outcome after transphyseal ACL reconstruction in children and adolescents regarding the femoral drilling technique. Methods A systematic literature search was carried out in various databases on studies on transphyseal ACL reconstruction in children and adolescents. The literature search was limited to the last 20 years. Primary outcome criterion was the failure rate. Secondary outcome criteria were growth disturbances such as leg length discrepancies or deformities and clinical scores. The present study was registered prospectively (www.crd.york.ac.uk/PROSPERO; CRD42022345964). Results A total of 22 retrospective or prospective case series (level 4 evidence) were identified that reported on transphyseal ACL reconstruction in children and adolescents. The overall failure/rupture rate after transphyseal ACL reconstruction was 11.0%. The overall ACL rupture rate of the contralateral side was 9.7%. No statistical significant difference in the failure rates between independent and transtibial drilling techniques could be detected ((p = 0.76/p = 0.28)). Furthermore no statistical significant differences in the rate of reported growth disturbances between independent and transtibial drilling techniques were shown (p = 0.15). The reported clinical scores at follow-up (mean follow-up 5.05 years) revealed good to very good results. Conclusion This systematic review demonstrates that children and adolescents have a relatively high failure rate after transpyseal ACL reconstruction without any statistically significant differences between independent or transtibial drilling techniques regarding reruptur rates or the rate of growth disturbances. The results of this systematic review warrant a comparison of both techniques for femoral tunnel drilling in a controlled randomized trial.

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Section: Resultsmentioning

confidence: 99%

A systematic review of transphyseal ACL reconstruction in children and adolescents: comparing the transtibial and independent femoral tunnel drilling techniques

et al. 2023

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“…As for autograft re-rupture rate, the result was nonsignificant. Some studies [10,11,[15][16][17][18][19][20][21][22][23] included other measurement methods (e.g., anterior drawer test, the Short Form mental/physical components, Lachman Grade and pivot shift test) to illustrate potential differences between the two surgical techniques. These results are not included in this study as the included studies did not have enough published data on these tests.…”

Section: Discussion Discussionmentioning

confidence: 99%

“…Of note, the rates of return to sports for Smith et al [10] were calculated from the percentages specified in the article. Furthermore, the study by Kilkenny et al [11] is represented twice in the analysis because this study comprised two groups in the original article; "13-15year olds" and "16-18-year olds". The groups are shown in Supplementary Figure 1B Supplementary Figure 1B in that order.…”

Section: Danish Medical Journal Danish Medical Journalmentioning

confidence: 99%

“…The 11 studies [10,11,[15][16][17][18][19][20][21][22][23] included in this review (2,489 patients) presented the results for the primary outcome: returning to the preinjury level of physical activity at the time of the final evaluation. These studies are shown in the overall analysis in Figure 3 Figure 3A.…”

Section: Risk Of Bias Analysis Risk Of Bias Analysismentioning

confidence: 99%

“…Five studies used the IKDC Subjective Score [11,16,17,22,23] presented in Supplementary Figure 1B Supplementary Figure 1B (n = 811 patients). The mean difference of the IKDC subjective score was higher for the HT group but was nonsignificant.…”

Section: Ikdc Subjective Score Ikdc Subjective Scorementioning

confidence: 99%

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Return to sports after anterior cruciate ligament surgery with hamstring or patella tendon autograft – a systematic review

Bouju,

Lauritzen,

Journé

et al. 2024

Dan Med J

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INTRODUCTION. In orthopaedics, anterior cruciate ligament (ACL) reconstructions are among the most common surgical interventions. Two methods are preferably used: autografts from the hamstring tendon (HT) or patella tendon (PT). The purpose of this meta-analysis was to compare these two methods when returning to sports. METHODS. Eleven studies were included based on a literature search conducted in PubMed. The primary outcome was return to preinjury sport level in athletes. Post-operative results such as the Lysholm score, the International Knee Documentation Committee (IKDC) subjective score, the Tegner Activity Score and KT-1000 arthrometry and autograft re-rupture rates were analysed as secondary outcomes. RESULTS. The analysis showed no significant difference in return to preinjury sports level at a two-year follow-up between patients operated with hamstring or patella autograft. Considering the secondary outcomes, no significant differences were recorded in Lysholm score, IKDC score or re-rupture rate. The Tegner Activity Scale demonstrated a significantly higher activity level in the PT group than in the HT group (OR 0.79, p = 0.003). At the two-year follow-up, the KT-1000 arthrometer analysis also showed a significant difference in laxity, which was higher for the HT autografts (OR –0.31, p = 0.02). CONCLUSION. This study showed no significant differences between hamstring and patella autografts. Even so, the choice of method when operated for ACL rupture remains crucial for the individual and should be a weighted decision made jointly by the patient and the physician.

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Return to play in paediatric & adolescent patients following anterior cruciate ligament reconstruction

Cited by 2 publications

References 21 publications

A systematic review of transphyseal ACL reconstruction in children and adolescents: comparing the transtibial and independent femoral tunnel drilling techniques

A systematic review of transphyseal ACL reconstruction in children and adolescents: comparing the transtibial and independent femoral tunnel drilling techniques

Return to sports after anterior cruciate ligament surgery with hamstring or patella tendon autograft – a systematic review

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