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Strides Seen in Orthopedic Surgery for Kids
Date:3/14/2010

Repairing ACL, meniscus at same time is one advance, 'Tommy John' elbow reconstruction another

SUNDAY, March 14 (HealthDay News) -- Repairing a torn knee meniscus at the same time as anterior cruciate ligament (ACL) reconstruction is safe and effective in children, a new study finds.

Meniscus cartilage acts as a cushion/shock absorber in the knee joint. The ACL is one of four major ligaments in the knee.

This study included 99 patients, 18 and younger, who had meniscus repair at the time of an ACL reconstruction. The overall success rate of meniscus repair was 74 percent. The rate was 84 percent for patients with simple tears (one major tear), 59 percent for displaced bucket-handle tears (a tear around the rim of the meniscus, causing the central portion to displace into the joint), and 57 percent for complex tears (a tear in multiple planes).

The freedom-from-failure rate was 90.9 percent after two years and 76.8 percent after eight years.

Knee function on a 100-point scale improved from a median of 48 (range of 38-70) before surgery to 90 (range of 52-100) after surgery. On a sporting activity scale of 0-10 (with 10 being national elite competitive sports), the patients improved from 1.9 before surgery to 6.2 after surgery.

"We have a wealth of information regarding adults who have a meniscus tear repaired at the time of ACL reconstruction, but there was very little data regarding the pediatric population," Dr. Aaron Krych, chief resident in the orthopedic surgery department at the Mayo Clinic, Rochester, Minn., said in a news release. "To our knowledge, this is the largest study reported on the pediatric population. These knee injuries are common in kids that play football, wrestling and soccer."

The study was to be presented Saturday at the American Orthopaedic Society for Sports Medicine's annual meeting in New Orleans.

At the same meeting, another team of researchers sa
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