IC 207-2024: Surgical Techniques for ACL Reconstruction in Patients with Open Physes-IC207_Surgical Techniques for ACL Reconstruction in Patients with Open Physes_V2.mp4IC207_Surgical Techniques for ACL Reconstruction in Patients with Open Physes

IC207_Surgical Techniques for ACL Reconstruction in Patients with Open Physes_V2.mp4IC207_Surgical Techniques for ACL Reconstruction in Patients with Open Physes

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Video Summary

In this instructional video course from the University of Torino, Italy, hosted by Davide Bonazia, the focus is on techniques for anterior cruciate ligament (ACL) reconstruction in pediatric patients. Multiple expert speakers detailed different methods tailored to the unique needs and anatomical considerations of children and adolescents. <br /><br />Key points included:<br />1. <strong>ACL Repair Indications</strong>: Optimal for cases with proximal avulsions and significant preservation of the ACL stump. Repair is favored in prepubescent patients to minimize growth disturbances.<br /><br />2. <strong>Surgical Techniques</strong>:<br />   - <strong>Bonazia's Method</strong>: Involves arthroscopic evaluation and minimally invasive procedures to ensure proper ACL stump visualization and preservation.<br />   - <strong>Zaffagnini's Technique</strong>: Uses hamstring tendon grafts passed in a sparing manner across the growth plate, emphasizing non-femoral tunnels to reduce growth disruption.<br />   - <strong>Rebo's Coker-MacKinley Technique</strong>: Preferential for very young, prepubescent patients, emphasizing the safety of growth structures with simple, cost-effective implementation.<br />   - <strong>Green's All-Epiphyseal Method</strong>: Developed by Alan Anderson, using sockets instead of full tunnels to reduce physeal damage. Later discussion highlighted a shift towards modified techniques due to observed growth disturbances.<br /><br />3. <strong>Growth Considerations and Complications</strong>: Speakers emphasized careful monitoring for growth disturbances post-surgery through regular imaging and adjusting techniques as needed to avoid compromising the growth plate.<br /><br />4. <strong>Return to Sport Testing</strong>: Effectiveness and guidelines were discussed, emphasizing the importance of thorough, individualized testing protocols to minimize risks of re-injury. Criteria included strength, hop tests, and psychological readiness measures.<br /><br />5. <strong>Respective Expert Recommendations</strong>: <br />   - Transition towards techniques that balance anatomical repair while minimizing invasiveness.<br />   - Surgical decisions should be individualized based on age, growth potential, and sport-specific demands.<br />   - Monitoring and safeguarding long-term limb health are essential, particularly in high-risk, active pediatric populations.<br /><br />The course underscored the complexity and delicacy of pediatric ACL reconstruction, advocating for tailored surgical approaches that prioritize minimizing growth disruptions and supporting successful, safe returns to sports.

Keywords

ACL reconstruction

pediatric patients

University of Torino

Davide Bonazia

surgical techniques

growth considerations

Bonazia's method

Zaffagnini's technique

Rebo's Coker-MacKinley technique

Green's all-epiphyseal method

return to sport testing

growth disturbances

individualized protocols