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Secondary injuries of anterior cruciate ligament after reconstruction in children and adolescents.
Author(s):
Pilecki G. (Poland)
,
Pilecki G. (Poland)
Affiliations:
Pilecki Z.
,
Pilecki Z.
Affiliations:
Kurzak Anna
,
Kurzak Anna
Affiliations:
Ciekalski J.
Ciekalski J.
Affiliations:
ESSKA Academy. Pilecki G. May 9, 2018; 209478; P06-1256 Topic: Knee
Dr. Grzegorz Pilecki
Dr. Grzegorz Pilecki
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Abstract
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Objectives: With the increase in sports activity of children and adolescents, more frequent injuries to the knee are observed, including total injury to the anterior cruciate ligament. Patients under the age of 18 who are undergoing reconstruction of the anterior cruciate ligament are statistically more likely to be prone to secondary damage.
The aim is to assess the incidence of secondary injuries of anterior cruciate ligament reconstruction in children and adolescents and the factors that may contribute to the reduction of these lesions.

Methods: The study involved 107 patients who had made a reconstruction of the anterior cruciate ligament in 2011-2013. Lysholm scales, Tegner scales were used for clinical evaluation. The degree of return to the sport and the number of revision procedures were assessed. Patients age ranged from 14 to 18 years (mean 16.5). Patients were evaluated prospectively. The study was conducted between 4-6 and between 9-12 months after reconstruction.

Results: Patients were divided into two groups. Group I consisted of 35 patients who underwent reconstruction of the anterior cruciate ligament with remnant preservation. Group II consisted of 72 patients who underwent reconstruction with removal of the old ligament remnant. Postoperative outcomes after 9-12 months in group I patients were better than in group II, but they were not statistically significant (93.67 vs 90.61 in Lysholm scale). The results after 4-6 months in patients in group I were slightly worse (85.4 to 86 by Lysholm scale). The preoperative outcome was 60.85 for group I, compared with 61.0 for group II, according to Lysholm scale. None of the patients in group I had complete damage to the ligament in relation to 2 patients in group II who underwent revision reconstruction. In 1 patient in group I partial damage to the anterior cruciate ligament was observed, compared to 9 in group II. In 4 patients in group I there was secondary damage to the meniscus, compared to 6 in group II.

Conclusions: 1) Reconstruction of the anterior cruciate ligament in patients under 18 years of age is characterized by a very good and good clinical outcome in most cases. 2) Reconstruction of the anterior cruciate ligament compared to adults is characterized by a higher rate of secondary injuries. 3) Reconstruction of the anterior cruciate ligament with remnant preservation may affect the number of better results, but further observations are needed.

Keywords:
knee, ACL, reconstruction, pediatric, adolescent,
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