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Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries
INTRODUCTION: The frequency of anterior cruciate ligament (ACL) injuries is increasing in pediatric and adolescent patients. Most surgeons elect to reconstruct the ACL in young, active patients to facilitate the resumption of sports and restore stability to the knee. Surgical technique and graft typ...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112830/ http://dx.doi.org/10.1177/2325967121S00392 |
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author | Nice, Emily Uquillas, Carlos Heidel, Eric |
author_facet | Nice, Emily Uquillas, Carlos Heidel, Eric |
author_sort | Nice, Emily |
collection | PubMed |
description | INTRODUCTION: The frequency of anterior cruciate ligament (ACL) injuries is increasing in pediatric and adolescent patients. Most surgeons elect to reconstruct the ACL in young, active patients to facilitate the resumption of sports and restore stability to the knee. Surgical technique and graft type preferences depend on the surgeon and skeletal maturity of the patient, but there is no clear standard based on age. HYPOTHESIS/PURPOSE: This study aims to evaluate physicians’ preferences for choosing a surgical plan for pediatric and adolescent patients with an ACL injury. METHODS: A voluntary survey link was sent to members of Pediatric Research in Sports Medicine (PRiSM). Consent was obtained by the participants taking part in the survey. RESULTS: Forty-five (n=45) physician responses were included in this analysis. Seven were female, thirty-six male, and one preferred not to answer. Twenty completed pediatric orthopaedic fellowships, six completed sports medicine fellowships, and nineteen completed both pediatric orthopaedic and sports medicine fellowships. Thirty-five respondents reported that greater than 75% of their patients were 18 years old or younger. The majority prefer the over the top technique for 8 to 10-year-old males over the all epiphyseal, partial transphyseal, and transphyseal techniques. The technique preference is split for 11, 12, and 13-year-old males. Twenty-five respondents prefer the partial transphyseal technique for 14-year-old male patients. A majority (n=42, n=43) prefer the transphyseal technique for 16 year old males and skeletally mature males. The technique preferences for female patients 9 years or less is the over the top technique. The technique preference is split for 10, 11, 12, and 13-year-old females. The majority (n=37, n=44, n=44) prefer the transphyseal technique for 14-year-old, 16-year-old, and skeletally mature female patients. The graft preference for males 11 years old or younger is the iliotibial band (ITB). The graft preference for males 12-year-old and older was split among the hamstring, ITB, bone-tendon-bone (BTB) and quadriceps grafts. When looking at the preferred graft for female patients, a majority prefer ITB for patients 10-years-old and younger. The participants’ graft preferences for female patients 11-years-old and older is split. CONCLUSION: Results of this survey suggest that graft type and surgical technique preferences for pediatric and adolescent patients with ACL tears change based on the patient’s age, with more agreement among surgeons at the extremes of patient ages. Further research is needed to track the impact of each surgical technique and graft choice on pediatric and adolescent patients. |
format | Online Article Text |
id | pubmed-9112830 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-91128302022-05-18 Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries Nice, Emily Uquillas, Carlos Heidel, Eric Orthop J Sports Med Article INTRODUCTION: The frequency of anterior cruciate ligament (ACL) injuries is increasing in pediatric and adolescent patients. Most surgeons elect to reconstruct the ACL in young, active patients to facilitate the resumption of sports and restore stability to the knee. Surgical technique and graft type preferences depend on the surgeon and skeletal maturity of the patient, but there is no clear standard based on age. HYPOTHESIS/PURPOSE: This study aims to evaluate physicians’ preferences for choosing a surgical plan for pediatric and adolescent patients with an ACL injury. METHODS: A voluntary survey link was sent to members of Pediatric Research in Sports Medicine (PRiSM). Consent was obtained by the participants taking part in the survey. RESULTS: Forty-five (n=45) physician responses were included in this analysis. Seven were female, thirty-six male, and one preferred not to answer. Twenty completed pediatric orthopaedic fellowships, six completed sports medicine fellowships, and nineteen completed both pediatric orthopaedic and sports medicine fellowships. Thirty-five respondents reported that greater than 75% of their patients were 18 years old or younger. The majority prefer the over the top technique for 8 to 10-year-old males over the all epiphyseal, partial transphyseal, and transphyseal techniques. The technique preference is split for 11, 12, and 13-year-old males. Twenty-five respondents prefer the partial transphyseal technique for 14-year-old male patients. A majority (n=42, n=43) prefer the transphyseal technique for 16 year old males and skeletally mature males. The technique preferences for female patients 9 years or less is the over the top technique. The technique preference is split for 10, 11, 12, and 13-year-old females. The majority (n=37, n=44, n=44) prefer the transphyseal technique for 14-year-old, 16-year-old, and skeletally mature female patients. The graft preference for males 11 years old or younger is the iliotibial band (ITB). The graft preference for males 12-year-old and older was split among the hamstring, ITB, bone-tendon-bone (BTB) and quadriceps grafts. When looking at the preferred graft for female patients, a majority prefer ITB for patients 10-years-old and younger. The participants’ graft preferences for female patients 11-years-old and older is split. CONCLUSION: Results of this survey suggest that graft type and surgical technique preferences for pediatric and adolescent patients with ACL tears change based on the patient’s age, with more agreement among surgeons at the extremes of patient ages. Further research is needed to track the impact of each surgical technique and graft choice on pediatric and adolescent patients. SAGE Publications 2022-05-13 /pmc/articles/PMC9112830/ http://dx.doi.org/10.1177/2325967121S00392 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions. |
spellingShingle | Article Nice, Emily Uquillas, Carlos Heidel, Eric Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries |
title | Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries |
title_full | Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries |
title_fullStr | Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries |
title_full_unstemmed | Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries |
title_short | Physician Preferences on Surgical Technique and Graft Type for Anterior Cruciate Ligament (ACL) Reconstructions for Pediatric Patients with ACL Injuries |
title_sort | physician preferences on surgical technique and graft type for anterior cruciate ligament (acl) reconstructions for pediatric patients with acl injuries |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112830/ http://dx.doi.org/10.1177/2325967121S00392 |
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