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Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership
PURPOSE: The therapeutic algorithm of paediatric anterior cruciate ligament (ACL) tears remains controversial. The primary aim of the study was to describe variations in practice patterns among European Paediatric Orthopaedic Society (EPOS) and Pediatric Orthopaedic Society of North America (POSNA)...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808070/ https://www.ncbi.nlm.nih.gov/pubmed/31695820 http://dx.doi.org/10.1302/1863-2548.13.190074 |
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author | Accadbled, F. Gracia, G. Laumonerie, P. Thevenin-Lemoine, C. Heyworth, B. E. Kocher, M. S. |
author_facet | Accadbled, F. Gracia, G. Laumonerie, P. Thevenin-Lemoine, C. Heyworth, B. E. Kocher, M. S. |
author_sort | Accadbled, F. |
collection | PubMed |
description | PURPOSE: The therapeutic algorithm of paediatric anterior cruciate ligament (ACL) tears remains controversial. The primary aim of the study was to describe variations in practice patterns among European Paediatric Orthopaedic Society (EPOS) and Pediatric Orthopaedic Society of North America (POSNA) members with respect to management of ACL tears in skeletally immature patients. The secondary objective was to determine the number, type and severity of growth disturbances associated with ACL reconstruction (ACLR). METHODS: An email invitation to complete a 52-question survey was sent to all members of POSNA and EPOS. Data were collected automatically. Descriptive statistics were applied. RESULTS: In all, 305 (25.4%) surgeon members responded. Only 182 (60%) of the participants treated ACL injuries in skeletally immature patients and completed the survey. A total of 17% of EPOS and 70% of POSNA members recommended ACLR within three months for a prepubescent paediatric ACL tear. In total, 61% of POSNA and 83% of EPOS members recommended ACLR within three months for a pubescent paediatric ACL tear. Epiphyseal tunnels were the preferred technique in prepubescent children (43% at the tibia and 49% at the femur), while transphyseal tunnels were recommended preferentially in pubescent children (85% at the tibia and 63% at the femur). In all, 5.5% of participants reported growth disturbances after ACLR. CONCLUSION: Current practice patterns across the Atlantic remain varied and controversial. Consensus remains elusive; as such, research collaboration among societies will be important to develop an evidence-based treatment algorithm. The use of transphyseal tunnels has been reinforced. The number of cases of significant growth disturbance is minimal, yet worrisome. LEVEL OF EVIDENCE: II |
format | Online Article Text |
id | pubmed-6808070 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-68080702019-11-06 Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership Accadbled, F. Gracia, G. Laumonerie, P. Thevenin-Lemoine, C. Heyworth, B. E. Kocher, M. S. J Child Orthop Original Clinical Article PURPOSE: The therapeutic algorithm of paediatric anterior cruciate ligament (ACL) tears remains controversial. The primary aim of the study was to describe variations in practice patterns among European Paediatric Orthopaedic Society (EPOS) and Pediatric Orthopaedic Society of North America (POSNA) members with respect to management of ACL tears in skeletally immature patients. The secondary objective was to determine the number, type and severity of growth disturbances associated with ACL reconstruction (ACLR). METHODS: An email invitation to complete a 52-question survey was sent to all members of POSNA and EPOS. Data were collected automatically. Descriptive statistics were applied. RESULTS: In all, 305 (25.4%) surgeon members responded. Only 182 (60%) of the participants treated ACL injuries in skeletally immature patients and completed the survey. A total of 17% of EPOS and 70% of POSNA members recommended ACLR within three months for a prepubescent paediatric ACL tear. In total, 61% of POSNA and 83% of EPOS members recommended ACLR within three months for a pubescent paediatric ACL tear. Epiphyseal tunnels were the preferred technique in prepubescent children (43% at the tibia and 49% at the femur), while transphyseal tunnels were recommended preferentially in pubescent children (85% at the tibia and 63% at the femur). In all, 5.5% of participants reported growth disturbances after ACLR. CONCLUSION: Current practice patterns across the Atlantic remain varied and controversial. Consensus remains elusive; as such, research collaboration among societies will be important to develop an evidence-based treatment algorithm. The use of transphyseal tunnels has been reinforced. The number of cases of significant growth disturbance is minimal, yet worrisome. LEVEL OF EVIDENCE: II The British Editorial Society of Bone & Joint Surgery 2019-10-01 /pmc/articles/PMC6808070/ /pubmed/31695820 http://dx.doi.org/10.1302/1863-2548.13.190074 Text en Copyright © 2019, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Original Clinical Article Accadbled, F. Gracia, G. Laumonerie, P. Thevenin-Lemoine, C. Heyworth, B. E. Kocher, M. S. Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership |
title | Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership |
title_full | Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership |
title_fullStr | Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership |
title_full_unstemmed | Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership |
title_short | Paediatric anterior cruciate ligament tears: management and growth disturbances. A survey of EPOS and POSNA membership |
title_sort | paediatric anterior cruciate ligament tears: management and growth disturbances. a survey of epos and posna membership |
topic | Original Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808070/ https://www.ncbi.nlm.nih.gov/pubmed/31695820 http://dx.doi.org/10.1302/1863-2548.13.190074 |
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