Evidence map›Paper›PMID 32504159›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020

All-epiphyseal anterior cruciate ligament reconstruction produces good functional outcomes and low complication rates in pediatric patients: a systematic review.

Arnav Gupta, Tushar Tejpal, Ajaykumar Shanmugaraj, Nolan S Horner, Chetan Gohal, Moin Khan

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Review
  4. Article
  5. Article
  6. Article
  7. [Management status of anterior cruciate ligament injury in children and adolescents].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Arnav GuptaFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Tushar TejpalFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Ajaykumar ShanmugarajDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Nolan S HornerDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Chetan GohalDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Moin KhanDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. khanmm2@mcmaster.ca.ORCID http://orcid.org/0000-0002-8237-8095

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the literature on indications, outcomes, and complications in pediatric patients undergoing all-epiphyseal (AE) anterior cruciate ligament reconstruction (ACLR).

methodsPubMed, Medline, and Embase were searched for literature evaluating AE ACLR in pediatric patients. All included studies were assessed for quality using the Methodological Index for Non-Randomized Studies (MINORS). Descriptive statistics are presented where applicable.

resultsOverall, 17 studies comprising 545 patients, with a mean age of 12.0 ± 1.2 (range 8-19) met the inclusion criteria. The graft choices in this systematic review included hamstring tendon autografts (75.4%, n = 403), quadriceps tendon autograft (6.2%, n = 33), Achilles tendon allograft (3.6%, n = 19) and posterior tibialis tendon allograft in one patient (0.2%, n = 1). Time of return-to-sport ranged from 8 to 22 months. Postoperative subjective IKDC scores were above 90 points. The rate of return-to-sport after AE ACLR was 93.2% (n = 219/235) and 77.9% (n = 142/183) of patients returned to sport at pre-injury level. The overall complication rate was 9.8% (n = 53/545) with the most common complication being ACL re-rupture (5.0%; n = 27/545). Only 1.5% (n = 8/545) of patients demonstrated growth disturbances.

conclusionOverall, the AE ACLR technique can achieve good postoperative functional outcomes while notably minimizing the incidence of primary issue of physeal disruption and potential associated leg-length discrepancies. AE ACLR should be considered in pediatric patients with at least 2 years of skeletal growth remaining based on radiographic bone age to minimize the impact of growth-related complications. LEVEL OF EVIDENCE: IV (Systematic Review of Level III and IV evidence).

Indexed as

Anterior Cruciate Ligament ReconstructionAdolescentAnterior Cruciate Ligament InjuriesAthletic InjuriesChildGrowth PlateHumansPostoperative ComplicationsReturn to SportTendonsTransplantation, AutologousTransplantation, HomologousYoung AdultACLAll-epiphysealEpiphysesKneePediatrics

Identifiers

PMID32504159

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.