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Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates

PURPOSE: To evaluate short- to mid-term outcomes after arthroscopic operative fixation of tibial spine fractures in pediatric patients, to determine the incidence of further ipsilateral and contralateral knee injuries, and to describe associated meniscal pathology and intraoperative findings at the...

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Autores principales: Quinlan, Noah J., Hobson, Taylor E., Mortensen, Alexander J., Tomasevich, Kelly M., Adeyemi, Temitope, Maak, Travis G., Aoki, Stephen K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365202/
https://www.ncbi.nlm.nih.gov/pubmed/34430880
http://dx.doi.org/10.1016/j.asmr.2021.03.005
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author Quinlan, Noah J.
Hobson, Taylor E.
Mortensen, Alexander J.
Tomasevich, Kelly M.
Adeyemi, Temitope
Maak, Travis G.
Aoki, Stephen K.
author_facet Quinlan, Noah J.
Hobson, Taylor E.
Mortensen, Alexander J.
Tomasevich, Kelly M.
Adeyemi, Temitope
Maak, Travis G.
Aoki, Stephen K.
author_sort Quinlan, Noah J.
collection PubMed
description PURPOSE: To evaluate short- to mid-term outcomes after arthroscopic operative fixation of tibial spine fractures in pediatric patients, to determine the incidence of further ipsilateral and contralateral knee injuries, and to describe associated meniscal pathology and intraoperative findings at the time of tibial spine repair. METHODS: All patients under age 18 with a tibial spine fracture treated arthroscopically at 1 institution by 2 surgeons from 2008 through 2019 were identified by Current Procedural Terminology codes. Patients at least 1 year from their date of surgery were contacted to complete a questionnaire, which included the International Knee Documentation Committee (IKDC) form. Questions pertained to knee function, pain, and further injury or surgery on either knee. Patient charts, preoperative imaging, and operative reports were reviewed to determine demographic information, tibial spine fracture type, concomitant injuries, and intraoperative details. RESULTS: Sixty-six of 97 eligible patients (68%) completed questionnaires. Average age at initial surgery was 10.7 years (range, 4-17). Mean follow-up was 5.8 years (range, 1.0-11.9). Average IKDC score at follow-up was 91.4 (range, 62.1-100). Patients reported their knee as 92% of “normal” (range, 40-100). Thirty-five (53%) currently participate in sport; 6 (9%) remain limited because of instability and residual pain. Regarding pain on a visual analog scale, 94%, 95%, and 83% of patients reported less than a 3 at rest, with daily activity, and with sport, respectively. Seven patients (11%) had subsequent ACL rupture. Six patients (9%) underwent ACL reconstruction 3.1 years (range, 0.9-7) after initial repair. Fourteen patients (21%) required at least 1 additional procedure. Regarding the contralateral knee, there were no ACL or tibial spine injuries. Sixty-one (92%) patients were both satisfied and would definitely undergo the procedure again. CONCLUSIONS: Although many pediatric patients demonstrate excellent results after tibial spine repair at mean 5.8 years follow-up, 10.6% sustained an ipsilateral ACL rupture, and 21% required an additional procedure. No patient had a contralateral tibial spine or ACL injury. This is helpful when counseling patients regarding injury risk when returning to activity after tibial spine repair. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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spelling pubmed-83652022021-08-23 Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates Quinlan, Noah J. Hobson, Taylor E. Mortensen, Alexander J. Tomasevich, Kelly M. Adeyemi, Temitope Maak, Travis G. Aoki, Stephen K. Arthrosc Sports Med Rehabil Original Article PURPOSE: To evaluate short- to mid-term outcomes after arthroscopic operative fixation of tibial spine fractures in pediatric patients, to determine the incidence of further ipsilateral and contralateral knee injuries, and to describe associated meniscal pathology and intraoperative findings at the time of tibial spine repair. METHODS: All patients under age 18 with a tibial spine fracture treated arthroscopically at 1 institution by 2 surgeons from 2008 through 2019 were identified by Current Procedural Terminology codes. Patients at least 1 year from their date of surgery were contacted to complete a questionnaire, which included the International Knee Documentation Committee (IKDC) form. Questions pertained to knee function, pain, and further injury or surgery on either knee. Patient charts, preoperative imaging, and operative reports were reviewed to determine demographic information, tibial spine fracture type, concomitant injuries, and intraoperative details. RESULTS: Sixty-six of 97 eligible patients (68%) completed questionnaires. Average age at initial surgery was 10.7 years (range, 4-17). Mean follow-up was 5.8 years (range, 1.0-11.9). Average IKDC score at follow-up was 91.4 (range, 62.1-100). Patients reported their knee as 92% of “normal” (range, 40-100). Thirty-five (53%) currently participate in sport; 6 (9%) remain limited because of instability and residual pain. Regarding pain on a visual analog scale, 94%, 95%, and 83% of patients reported less than a 3 at rest, with daily activity, and with sport, respectively. Seven patients (11%) had subsequent ACL rupture. Six patients (9%) underwent ACL reconstruction 3.1 years (range, 0.9-7) after initial repair. Fourteen patients (21%) required at least 1 additional procedure. Regarding the contralateral knee, there were no ACL or tibial spine injuries. Sixty-one (92%) patients were both satisfied and would definitely undergo the procedure again. CONCLUSIONS: Although many pediatric patients demonstrate excellent results after tibial spine repair at mean 5.8 years follow-up, 10.6% sustained an ipsilateral ACL rupture, and 21% required an additional procedure. No patient had a contralateral tibial spine or ACL injury. This is helpful when counseling patients regarding injury risk when returning to activity after tibial spine repair. LEVEL OF EVIDENCE: Level IV, therapeutic case series. Elsevier 2021-06-14 /pmc/articles/PMC8365202/ /pubmed/34430880 http://dx.doi.org/10.1016/j.asmr.2021.03.005 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Quinlan, Noah J.
Hobson, Taylor E.
Mortensen, Alexander J.
Tomasevich, Kelly M.
Adeyemi, Temitope
Maak, Travis G.
Aoki, Stephen K.
Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates
title Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates
title_full Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates
title_fullStr Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates
title_full_unstemmed Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates
title_short Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates
title_sort tibial spine repair in the pediatric population: outcomes and subsequent injury rates
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365202/
https://www.ncbi.nlm.nih.gov/pubmed/34430880
http://dx.doi.org/10.1016/j.asmr.2021.03.005
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