Return to sport activity after anterior cruciate ligament reconstruction\ud in skeletally immature athletes with manual drilling original all inside\ud reconstruction at 8 years follow-up

摘要

Objective: Anterior cruciate ligament (ACL) tears are common injuries in adolescent athletes, especially\udin those who bear high stress on their knees due to shearing forces. The goal of the surgical procedures in\udskeletally immature patients is to restore joint stability avoiding the adverse effects on the growth\udprocess.\udThe aim of this study was to verify the return of the skeletally immature professional athletes to sports in\udthe long-term, following ACL reconstruction with the original all-inside technique and with manual\uddrilling.\udMethods: This study included 24 athletes (14 boys, 10 girls; mean age: 13.15 years, range: 9e14 years)\udwho had radiographic evidence of open physes, were less than 14 years of age at the time of surgery and\udthose with a minimum follow-up of eight years. All patients completed a questionnaire, the IKDC subjective\udknee evaluation form, and Tegner Activity Scale. Biomechanical outcomes of the KT-1000\udarthrometer, gait analysis, and stabilometric and isokinetic results were also evaluated. A plain radiograph\udof both lower limbs was taken to obtain a precise measurement of the limb length and mechanical\udaxis angles.\udResults: The patients returned to sport activities in a mean time of 6.43 months. No rerupture or\udresurgery due to growth abnormalities was observed. The mean difference in length between the\udoperated and contralateral legs was 0.4 (range: 0.2 to 0.7) cm. The mean side-to-side difference\udmeasured with the KT-1000 arthrometer was 5.2 (range: 3.5 to 7) mm in the preoperative and 0.8 (range:\ud0 to 2.5) mm in the postoperative measurements.\udConclusion: In conclusion, the original all-inside technique with manual drilling with a half tunnel and\udshort graft seems to be a very effective technique for the surgical management of ACL injuries in pediatric/\udadolescent athletes. A good rate of return to sports at pre-injury levels or higher, high patient\udsatisfaction and a decent motor and proprioceptive function is possible as shown by our analysis.\udLevel of evidence: Level IV, Therapeutic study.