scholarly journals Tratamento cirúrgico de lesão do ligamento cruzado anterior em paciente com imaturidade esquelética pela técnica de Kocher, com seguimento pós operatório de 6 anos: relato de caso / Surgical treatment of anterior cruciate ligament injury in a patient with skeletal immaturity by the Kocher technique, with a postoperative follow-up of 6 years: case report

2021 ◽  
Vol 66 ◽  
Author(s):  
Alfredo dos Santos Netto ◽  
Leticia Sano Kawano ◽  
Victor Marques De Oliveira ◽  
Nilson Roberto Severino ◽  
Osmar Pedro de Arbix de Camargo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Treatment ◽  
Cruciate Ligament ◽  
Pubertal Development ◽  
Ligament Injury ◽  
Reconstruction Technique ◽  
Anterior Cruciate ◽  
Physeal Sparing ◽  
Skeletal Immaturity

Introdução: No tratamento cirúrgico da lesão do ligamento cruzado anterior (LCA) em pacientes pediá-tricos, é necessário o equilíbrio entre a restauração da anatomia, e o risco de dano à fise de crescimento durante o ato operatório. Objetivo: Relatar caso de paciente com 9 anos, de-senvolvimento puberal de Tanner I, submetido a reconstrução do LCA pela técnica de Ko-cher, técnica de reconstrução extra fisária com enxerto de trato iliotibial autólogo.Palavras chave: Joelho, Reconstrução do ligamento cruzado anterior, Maturidade sexual AbstractIntroduction: In the surgical treatment of anterior cruciate ligament (ACL) injury in pediatric patients, a balance between anatomical restoration and the risk of damage to the growth plate during the surgery is necessary. Objective: Report a case of a 9-year-old patient, pubertal development of Tanner I, underwent ACL reconstruction using the technique of Kocher et al., a physeal-sparing reconstruction technique with autologous iliotibial tract graft.Keywords: Knee, Anterior cruciate ligament reconstruction, Sexual maturation

scholarly journals Evidence too weak to guide surgical treatment decisions for anterior cruciate ligament injury: a systematic review of the risk of new meniscal tears after anterior cruciate ligament injury

2020 ◽  
Vol 54 (9) ◽  
pp. 520-527 ◽  
Author(s):  
Guri Ranum Ekås ◽  
Clare L Ardern ◽  
Hege Grindem ◽  
Lars Engebretsen
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Surgical Treatment ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Meniscal Tears ◽  
Anterior Cruciate

ObjectiveTo investigate the risk of new meniscal tears after treatment for anterior cruciate ligament (ACL) injury, in children and adults with and without ACL reconstruction.DesignPrognosis systematic review (PROSPERO registration number CRD42016036788).MethodsWe searched Embase, Ovid Medline, Cochrane, CINAHL, SPORTDiscus, PEDro and Google Scholar from inception to 3rd May 2018. Eligible articles included patients with ACL injury (diagnosis confirmed by MRI and/or diagnostic arthroscopy), reported the number of meniscal tears at the time of ACL injury diagnosis/start of treatment and reported the number of new meniscal tears that subsequently occurred. Articles with fewer than 20 patients at follow-up, and articles limited to ACL revision surgery or multi-ligament knee injuries were excluded. Two independent reviewers screened articles, assessed eligibility, assessed risk of bias and extracted data. We judged the certainty of evidence using the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group methodology.ResultsOf 75 studies included in the systematic review, 54 studies with 9624 patients and 501 new meniscal tears were appropriate for quantitative analysis. Heterogeneity precluded data pooling. The risk of new meniscal tears was 0%–21% when follow-up was <2 years, 0%–29% when follow-up was 2 to 5 years, 5%–52% when follow-up was 5 to 10 years and 4%–31% when follow-up was longer than 10 years. The proportion of studies with high risk of selection, misclassification and detection bias was 84%, 69% and 68%, respectively. Certainty of evidence was very low.ConclusionNew meniscal tears occurred in 0%–52% of patients between 4 months and 20 years (mean 4.9±4.4 years) following treatment for ACL injury. The certainty of evidence was too low to guide surgical treatment decisions. This review cannot conclude that the incidence of new meniscal tears is lower if ACL injury is treated with surgery compared with treatment with rehabilitation only.

scholarly journals Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0003
Author(s):  
Agustin Bertona ◽  
Juan Pablo Zicaro ◽  
Juan Manuel Gonzalez Viescas ◽  
Nicolas Atala ◽  
Carlos Yacuzzi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Simultaneous Reconstruction ◽  
Anterior Cruciate ◽  
Grade Iii

Objectives: Combined Anterior Cruciate Ligament (ACL) injury and Medial Collateral Ligament (MCL) injury account for 20% of knee ligament lesions. Conservative treatment of MCL and surgical ACL reconstruction are generally recommended. Significant medial instability after non-surgical management of MCL can lead to ACL reconstruction failure. The optimal management for athletes with combined ACL-MCL injuries remains controversial. The purpose of this study was to analyze the functional and clinical evolution of patients who underwent combined ACL-MCL surgery and their return-to-sport level with minimum 2-years follow-up. Methods: A total of 20 athletes with acute simultaneous ACL/Grade III MCL reconstructions were treated between March 2006 and January 2014. The minimum follow-up time was 24 months. Subjective functional results (IKDC, Lysholm), range of motion, anterior-medial and rotational stability (Lachmann, Pivot Shift, valgus stress) were evaluated. The ability to return to sport (Tegner) and the level achieved was recorded. Results: All patients significantly improved functional scores and stability tests. The mean subjective IKDC score improved from 37.7 ± 12.9 (range 21-69) preoperatively to 88.21 ± 4.47 (range 80-96) postoperatively (P <0.05). The average Lysholm score was 40.44 ± 10.58 (range 27-65) preoperatively and 90.83 ± 3.38 (range 84-95) postoperatively (P <0.05). Valgus and sagittal laxity was not observed (IKDC A 92% B 8%) at final follow-up. All patients had normal/nearly normal (IKDC A or B) mobility. All patients returned to sports; 90% reached the level they had prior to the ligamentous injury. Of all competitive athletes, 66% achieved the same level of sport. Conclusion: In athletes with acute ACL-Grade III MCL lesions, an early simultaneous reconstruction can significantly improve the medial and sagittal stability of the knee. This procedure resulted in excellent functional outcomes, with return to the same level of sports in the majority of patients at short-term follow-up.

Surgical treatment of anterior cruciate ligament injury in adults

2016 ◽  
Vol 77 (4) ◽  
pp. 227-231 ◽  
Author(s):  
Sulaiman Alazzawi ◽  
Mohamed Sukeik ◽  
Mazin Ibrahim ◽  
Fares S Haddad
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Treatment ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Anterior Cruciate
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