All-epiphyseal Anterior Cruciate Ligament Reconstruction Does Not Increase the Risk of Complications Compared With Pediatric Transphyseal Reconstruction.

This study compares clinical outcomes and complications between all-epiphyseal and pediatric transphyseal ACLR. METHODS: We retrospectively reviewed 1,056 pediatric patients undergoing primary ACLR between 2000 and 2015. Of these, 51 were excluded (5 extra-articular and 46 partial transphyseal reconstructions). Demographic data, intraoperative findings and techniques, postoperative complications (including graft rupture, contralateral anterior cruciate ligament [ACL] tear, and meniscus injuries), clearance for sports, range of motion (ROM), and isokinetic strength testing were recorded. Univariate analysis was followed by stepwise, binary logistic regressions to control for confounding factors. RESULTS: During the study period, 162 patients underwent all-epiphyseal reconstruction (mean age, 12.1 ± 1.8 years) and 843 underwent transphyseal ACLR (mean age, 15.8 ± 1.9 years). At the time of surgery, more meniscus tears were found in the transphyseal group (76% versus 60%; P < 0.01). These patients also had more irreparable meniscus tears requiring partial meniscectomy (35% versus 18%; P < 0.01). Overall, the rates of graft failure, contralateral ACL injury, and new meniscus tears were 10.3%, 6.1%, and 14.2%, respectively. After controlling for confounders in a multivariate model, no difference was found in these postoperative complications between all-epiphyseal and transphyseal ACLR. Furthermore, no clinically significant difference was observed in posto...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research