PMID- 36579042
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230103
IS  - 2666-061X (Electronic)
IS  - 2666-061X (Linking)
VI  - 4
IP  - 6
DP  - 2022 Dec
TI  - Combining Anterior Cruciate Ligament Reconstruction With Lateral Extra-Articular 
      Procedures in Skeletally Immature Patients Is Safe and Associated With a Low 
      Failure Rate.
PG  - e1941-e1951
LID - 10.1016/j.asmr.2022.08.002 [doi]
AB  - PURPOSE: To analyze the rates of graft ruptures and growth disorders, the level 
      of return to sport, and the clinical results of 2 lateral extra-articular 
      procedures in growing children. METHODS: This study was a retrospective, 
      single-center study of patients undergoing anterior cruciate ligament (ACL) 
      surgery combined with 2 different lateral extra-articular procedures (anatomic 
      reconstruction with a gracilis graft or modified Lemaire technique with a strip 
      of fascia lata). The measurements of side-to-side anterior laxity and pivot shift 
      were performed preoperatively and at the last follow-up. The sports level and the 
      complications rate were assessed. The minimal clinically important differences 
      (MCID) and patient acceptable symptoms state threshold scores were calculated. 
      RESULTS: Thirty-nine patients (40 ACLs) were included (20 anatomic and 20 
      modified Lemaire) at an average follow-up of 57 months +/- 10 [42-74]. One patient 
      (2.5%) was lost to follow-up. The mean age at surgery was 13.8 +/- 1.4 years old 
      [9.8; 16.5]. One graft failure was reported (2.6% [0.06-13.5]) at 35.6 months 
      after surgery. Two cases (5.4%) of femoral overgrowth were observed, and one of 
      them required distal femoral epiphysiodesis. Ninety-two percent of the patients 
      returned to sports. At the final follow-up, side-to-side anterior laxity was 
      significantly improved, and no residual pivot shift was recorded in 95% of 
      patients. Eighty-nine percent of the patients presented a Pedi-International Knee 
      Documentation Committee score greater than the MCID postoperatively, and 77% 
      presented a Lysholm score greater than the MCID. CONCLUSIONS: This series of ACL 
      reconstructions combined with 2 different lateral extra-articular procedures in 
      skeletally immature patients demonstrated promising findings. The low rate of 
      observed complications, including graft rupture and growth disturbance, is 
      encouraging, but the small study population and lack of comparative group 
      precludes reliable conclusions. LEVEL OF EVIDENCE: IV, therapeutic case series.
CI  - (c) 2022 The Authors.
FAU - Foissey, Constant
AU  - Foissey C
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Thaunat, Mathieu
AU  - Thaunat M
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Caron, Etienne
AU  - Caron E
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Haidar, Ibrahim
AU  - Haidar I
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Vieira, Thais Dutra
AU  - Vieira TD
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Gomes, Lucas
AU  - Gomes L
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Freychet, Benjamin
AU  - Freychet B
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Sonnery-Cottet, Bertrand
AU  - Sonnery-Cottet B
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
FAU - Fayard, Jean-Marie
AU  - Fayard JM
AD  - Centre Orthopedique Santy, Lyon; and Hopital Prive Jean Mermoz, Ramsay-Generale 
      de Sante, Lyon, France.
LA  - eng
PT  - Journal Article
DEP - 20221009
PL  - United States
TA  - Arthrosc Sports Med Rehabil
JT  - Arthroscopy, sports medicine, and rehabilitation
JID - 101765256
PMC - PMC9791843
EDAT- 2022/12/30 06:00
MHDA- 2022/12/30 06:01
PMCR- 2022/10/09
CRDT- 2022/12/29 02:43
PHST- 2021/12/03 00:00 [received]
PHST- 2022/08/01 00:00 [accepted]
PHST- 2022/12/29 02:43 [entrez]
PHST- 2022/12/30 06:00 [pubmed]
PHST- 2022/12/30 06:01 [medline]
PHST- 2022/10/09 00:00 [pmc-release]
AID - S2666-061X(22)00133-X [pii]
AID - 10.1016/j.asmr.2022.08.002 [doi]
PST - epublish
SO  - Arthrosc Sports Med Rehabil. 2022 Oct 9;4(6):e1941-e1951. doi: 
      10.1016/j.asmr.2022.08.002. eCollection 2022 Dec.