Objective: To examine the proportion of skeletally immature anterior cruciate ligament reconstructed (ACLR) patients who achieve ≥90% of lower extremity recovery at 6-9 months post-operatively.
Design: Cross-sectional study.
Setting: Biomechanical laboratory.
Participants: Skeletally immature ACLR patients.
Main Outcome Measure(s): Muscular strength (quadriceps, hamstrings, hip abductors, and hip extensors), dynamic balance (anterior reach, posteromedial reach, and posterolateral reach), and functional hops tests (single hop, triple hops, cross-over hops, and 6 m timed hops) were examined. The primary outcome variable was the proportion of the study patients whose limb symmetry index (LSI) were ≥90% during return to sport (RTS) tests.
Results: A total of 105 skeletally immature ACLR patients who are planning to return to sporting activities (age: 13.4 ± 1.4 years) were enrolled. The proportion of skeletally immature ACLR patients who achieved ≥90% of LSI in all four strength, three balance, and four hop tests were 20.0%, 65.4%, and 27.8%. In those who completed all test battery (72/105), only 4.2% of skeletally immature ACLR patients demonstrated ≥90% of LSI in all RTS tests.
Conclusion: A small proportion of skeletally immature ACLR patients demonstrated ≥90% of lower extremity recovery approximately at 7 months following ACLR.
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http://dx.doi.org/10.1016/j.ptsp.2020.05.007 | DOI Listing |
Iowa Orthop J
January 2025
Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Background: Trochleoplasty is a surgical consideration for the treatment of high-grade trochlear dysplasia. The safety profile of this procedure remains particularly unclear in the skeletally immature population where concerns exist regarding physeal arrest and the development of premature patellofemoral arthritis. The purpose of this study was to systematically review the literature to evaluate trochleoplasty use, outcomes and complications observed among pediatric patients.
View Article and Find Full Text PDFJ Pediatr Orthop
January 2025
Department of Orthopaedics, Hôpital des Enfants.
Background: The failure rate of anterior cruciate ligament (ACL) reconstruction in children and adolescents is a significant concern. Of the multitude of clinical factors that contribute to this risk, delayed maturation and graft laxity are potentially related and modifiable elements. The aim was to investigate knee anterior laxity and graft maturation in children and adolescents.
View Article and Find Full Text PDFJ Pediatr Orthop
January 2025
Division of Orthopaedic Surgery, Rady Children's Hospital-San Diego, San Diego, CA.
Background: Distal radius physeal injuries can result in growth arrest and progressive deformity in children. Ulnar epiphysiodesis may be used to prevent deformity in the skeletally immature child; however, predicting success may be challenging. The purpose of this study was to (1) develop a method to predict successful ulnar epiphysiodesis, and (2) determine the utility of adding a sliding bone autograft as an adjunct to achieving successful epiphysiodesis.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
The medial patellofemoral complex provides the primary static restraint to lateral patellar translation and is composed of the medial patellofemoral ligament and medial quadriceps tendon femoral ligament. Multiple techniques including medial patellofemoral ligament and/or medial quadriceps tendon femoral ligament reconstruction have demonstrated good results; however, modification of the femoral fixation technique is required for skeletally immature patients or revision cases in which anatomic bony fixation on the femur is not possible. This technique describes an all-soft-tissue procedure for single-bundle medial patellofemoral complex reconstruction in which the graft is fixed on the adductor tendon while using the medial collateral ligament as a distalizing pulley, for anatomic and isometric recreation of the native ligament.
View Article and Find Full Text PDFJ Orthop Trauma
January 2025
Geisinger Health System, Department of Orthopaedic Surgery, Danville, PA.
Objectives: To explore outcomes after tibial rigid intramedullary nailing (RIMN) in skeletally immature patients, with a focus on post-operative complications and iatrogenic changes in tibial slope due to anterior physeal arrest.
Methods: Design: Retrospective case series.
Setting: A large, tertiary care health system in the rural Mid-Atlantic United States, including two Level 1 trauma centers and one Level 2 trauma center.
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