完全经骺板重建术治疗青少年前交叉韧带损伤的疗效分析

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (5865 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To evaluate the clinical effect of anterior cruciate ligament injury in adolescents with transphyseal for anterior cruciate ligament reconstruction.
Methods The clinical data of 14 adolescent anterior cruciate ligament reconstructed by transphyseal of body tendon from December 2017 to January 2020 were retrospectively analyzed.There were 6 males and 8 females.The age ranged from 14 to 16 years，with an average of (15.1±0.7)years.The time from injury to operation ranged from 10 to 96 days，with an average of (40.3±33.0)days.The preoperative drawer test and Lachman test were positive，and the preoperative imaging examination suggested anterior cruciate ligament injury and epiphyseal closure.Standing fulllength radiographs of lower limbs were taken before and at the last followup，and range of motion(ROM)，visual analog scale(VAS)，Lysholm score and international knee documentation committee(IKDC) score and Tegner score.At the same time，Tegner score before injury，postoperative return to sports time and height increase was recorded to evaluate the efficacy.
Results All 14 patients were followed up for 25~51 months，with an average of (34.8±9.6)months.At the last follow-up，the patient's height increased from 4.3 to 14.6 cm，with an average of (8.5±3.0)cm.11 patients were negative in the front drawer test and Lachman test，and 3 patients were negative in the front drawer test and weakly positive in the Lachman test.The time to return to sports was 8~14 months，with an average of (10.6±1.8)months.ROM of the knee joint was improved from preoperative (53.2±21.8)° to (135.8±3.6)°，VAS score was improved from preoperative (4.7±1.7)point to (0.2±0.4)point，and Lysholm score was improved from preoperative (56.6±8.2)point to (95.5±2.8)point.IKDC score improved from (66.7±7.4)points to (93.7±2.6)points，and Tegner score improved from (2.4±0.8)points to (6.7±1.7)points.The differences were statistically significant (P＜0.05).There was no significant difference compared with before injury (P>0.05).Standing fulllength radiographs of both lower limbs indicated that the epiphysis was closed in all patients，with no unequal length of both lower limbs and varus and varus deformity of the knee joint.Conclusion Transphyseal anterior cruciate ligament reconstruction for treatment of adolescent anterior cruciate ligament injury can obtain good effectiveness，the knee function is significantly improved，and early follow-up shows no significant effect on bone growth and development of lower limbs.

Key words： anterior cruciate ligament adolescent transphyseal

Corresponding Authors: Li Zhong

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Li Jun
	Liu Juncai
	Li Yuan
	Li Lingzhi
	He Yanwei
	Jiang Hao
	Li Zhong

Cite this article:

Li Jun,Liu Juncai,Li Yuan, et al. The Effect of Anterior Cruciate Ligament Reconstruction in Adolescents Using the Transphyseal Technique[J]. sygkzz, 2022, 28(09): 787-.

URL:

http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I09/787

［1］Nogaro Mc，Abram SGF，Alvand A，et al.Paediatric and adolescent anterior cruciate ligament reconstruction surgery［J］.Bone Joint J，2020，102-b(2)：239-245.
［2］Raad M，Thevenin Lemoine C，Berard E，et al.Delayed reconstruction and high BMI z score increase the risk of meniscal tear in paediatric and adolescent anterior cruciate ligament injury［J］.Knee Surg Sports Traumatol Arthrosc，2019，27(3)：905-911.
［3］James EW，Dawkins BJ，Schachne JM，et al.Early cperative versus delayed operative versus nonoperative treatment of pediatric and adolescent anterior cruciate ligament injuries：a systematic review and metaanalysis［J］.Am J Sports Med，2021，49(14)：4008-4017.
［4］Cristiani R，Janarv PM，Engstrom B，et al.Delayed anterior cruciate ligament reconstruction increases the risk of abnormal prereconstruction laxity，cartilage，and medial meniscus injuries［J］.Arthroscopy，2021，37(4)：1214-1220.
［5］Domzalski M，Karauda A，Grzegorzewski A，et al.Anterior cruciate ligament reconstruction using the transphyseal technique in prepubescent athletes：midterm，prospective evaluation of results［J］.Arthroscopy，2016，32(6)：1141-1146.
［6］李强强，陈东阳，姚尧，等.完全经骺板自体半腱肌、股薄肌肌腱重建治疗青少年前十字韧带损伤［J］.中华骨科杂志，2017，37(7)：425-432.
［7］Chambers CC，Monroe EJ，Allen CR，et al.Partial transphyseal anterior cruciate ligament reconstruction：clinical，functional，and radiographic outcomes［J］.Am J Sports Med，2019，47(6)：1353-1360.
［8］Fury MS，Paschos NK，Fabricant PD，et al.Assessment of skeletal maturity and postoperative growth disturbance after anterior cruciate ligament reconstruction in skeletally immature patients：A systematic review［J］.Am J Sports Med，2022，50(5)：1430-1441.
［9］Holwein C，Hinterwimmer S，Mayr HO，et al.Functional outcome after transphyseal anterior cruciate ligament reconstruction in young patients with open growth plates［J］.Knee，2016，23(6)：1121-1132.
［10］Thienpont E，Schwab PE，Cornu O，et al.Bone morphotypes of the varus and valgus knee［J］.Arch Orthop Trauma Surg，2017，137(3)：393-400.
［11］Collins MJ，Arns TA，Leroux T，et al.Growth abnormalities following anterior cruciate ligament reconstruction in the skeletally immature p atient：a systematic review［J］.Arthroscopy，2016，32(8).1714-1723
［12］刘宇，孙振中，顾三军，等.青少年前交叉韧带重建2例报告及文献复习［J］.实用骨科杂志，2014，20(2)：185187.
［13］Pierce TP，Issa K，Festa A，et al.Pediatric anterior cruciate ligament reconstruction：A systematic review of transphyseal versus physeal-sparing techniques［J］.Am J Sports Med，2017，45(2)：488-494.
［14］Mccarthy CJ，Harty JA.Follow-up study on transphyseal ACL reconstruction in Irish adolescents with no cases of leg length discrepancy or angular deformity［J］.Ir J Med Sci，2020，189(4)：1323-1329.
［15］Calvo R，Figueroa D，Gili F，et al.Transphyseal anterior cruciate ligament reconstruction in patients with open physes：10-year follow-up study［J］.Am J Sports Med，2015，43(2)：289-294.
［16］Heath MR，Aitchison AH，Schlichte LM，et al.Use caution when assessing preoperative leg-length discrepancy in pediatric patients with anterior cruciate ligament injuries［J］.Am J Sports Med，2020，48(12)：2948-2953.
［17］Price MJ，Tuca M，Cordasco FA，et al.Nonmodifiable risk factors for anterior cruciate ligament injury［J］.Curr Opin Pediatr，2017，29(1)：55-64.
［18］Bisciotti GN，Chamari K，Cena E，et al.Anterior cruciate ligament injury risk factors in football［J］.J Sports Med Phys Fitness，2019，59(10)：1724-1738.
［19］Kay J，Memon M，Marx RG，et al.Over 90% of children and adolescents return to sport after anterior cruciate ligament reconstruction：A systematic review and meta-analysis［J］.Knee Surg Sports Traumatol Arthrosc，2018，26(4)：1019-1036.
［20］Dekker TJ，Godin JA，Dale KM，et al.Return to sport after pediatric anterior cruciate ligament reconstruction and its effect on subsequen t anterior cruciate ligament injury［J］.J Bone Joint Surg (Am)，2017，99(11)：897-904.
［21］Armento A，Albright J，Gagliardi A，et al.Patient expectations and perceived social support related to return to sport after anterior cruciate ligament reconstruction in adolescent athletes［J］.Phys Ther Sport，2021(47)：72-77.
［22］Hamrin SE，Seil R，Svantesson E，et al.“I never made it to the pros…” Return to sport and becoming an elite athlete after pediatric and adolescent anterior cruciate ligament injury-Current evidence and future directions［J］.Knee Surg Sports Traumatol Arthrosc，2018，26(4)：1011-1018.