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儿童前交叉韧带重建——经骨骺技术的疗效与安全性评估

Pediatric ACL Reconstruction in Children-An Evaluation of the Transphyseal Technique's Efficacy and Safety.

作者信息

Herdea Alexandru, Dragomirescu Mihai-Codrut, Burcan Valentin, Ulici Alexandru

机构信息

11th Department of Pediatric Orthopedics, "Carol Davila" University of Medicine and Pharmacy, Bd. Eroii Sanitari Nr. 8, 050474 Bucharest, Romania.

Pediatric Orthopedics Department, "Grigore Alexandrescu" Children's Emergency Hospital, 011743 Bucharest, Romania.

出版信息

Children (Basel). 2024 May 3;11(5):545. doi: 10.3390/children11050545.

Abstract

INTRODUCTION

Injuries of the anterior cruciate ligament (ACL) are commonly found in the general population, both among adult and pediatric patients, and their incidence has been increasing in recent years. Most of the late literature agrees that surgical reconstruction of the ACL is effective in improving long-term outcomes in pediatric patients, while others in the past have pleaded for non-surgical management.

PURPOSE/HYPOTHESIS: Our study aims to verify if ACL reconstruction (ACLR) using transphyseal technique in skeletally immature patients will provide angular deviations or growth restrictions.

STUDY DESIGN

Retrospective cohort study; Level of evidence 4.

METHODS

We perfomed a retrospective study to verify if transphyseal ACLR in children with less than or equal to 2 years of remaining growth leads to either limb length discrepancies or axis deviations.

RESULTS

Most patients who were treated using transphyseal technique showed significant improvements in their functional scores. There were statistically significant differences in lateral distal femoral angles (LDFA) and medial proximal tibial angles (MPTA), with no clinical impact. There was no significant limb length discrepancy (LLD) during the 2-year follow-up.

CONCLUSIONS

Transphyseal ACLR is safe among children who have less than or equal to 2 years of remaining growth and brings no risk of axis deviations or limb length discrepancy.

摘要

引言

前交叉韧带(ACL)损伤在普通人群中很常见,在成人和儿童患者中均有发现,且近年来其发病率一直在上升。大多数近期文献一致认为,ACL手术重建对改善儿童患者的长期预后有效,而过去其他人则主张非手术治疗。

目的/假设:我们的研究旨在验证在骨骼未成熟患者中使用经骨骺技术进行ACL重建(ACLR)是否会导致角度偏差或生长受限。

研究设计

回顾性队列研究;证据等级为4级。

方法

我们进行了一项回顾性研究,以验证在剩余生长时间小于或等于2年的儿童中进行经骨骺ACLR是否会导致肢体长度差异或轴线偏差。

结果

大多数采用经骨骺技术治疗的患者功能评分有显著改善。外侧股骨远端角(LDFA)和内侧胫骨近端角(MPTA)存在统计学上的显著差异,但无临床影响。在2年随访期间,没有明显的肢体长度差异(LLD)。

结论

在剩余生长时间小于或等于2年的儿童中,经骨骺ACLR是安全的,不会带来轴线偏差或肢体长度差异的风险。

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