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Purpose: Graft failure rates after anterior cruciate ligament reconstruction (ACLR) in children and adolescents are higher compared to adults. Anterolateral augmentation procedures have recently generated increased focus regarding their ability to reduce graft failure rates. Concerns in skeletally immatures are potential growth disturbances and overconstraint after anterolateral augmentation. The aim of this scoping review is to provide an overview of all current anterolateral augmentation procedures in skeletally immature patients and to discuss surgical techniques, clinical and biomechanical outcomes. Methods: This scoping review was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analysis) statement extension for scoping reviews. On 22 December 2022, an information specialist performed a systematic literature search in Cochrane, PubMed (Medline) and EMBASE databases. Inclusion criteria were anterolateral augmentation procedures, including lateral extra‐articular tenodesis (LET) and anterolateral ligament reconstruction (ALLR), in combination with ACLR in skeletally immatures. Results: Twenty studies were included after screening 1.485 abstracts. Seventeen studies describe LET techniques, four studies ALLR techniques and one study both techniques. Biomechanical data is scarce and shows conflicting results. Two studies compared ACLR with LET to ACLR in skeletally immatures with promising results in favour of the combined procedure. There were no differences in outcomes between LET and ALLR. Conclusions: Several LET and ALLR techniques have been described for skeletally immature patients and the first clinical data on LET and ALLR is available, which showed promising results. Further research is necessary to evaluate the risk of growth disturbances and overconstraint in skeletally immatures. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

The hypothesis was that an increased lateral tibial slope, a decreased femoral flat surface, a decreased meniscal bone angle and a decreased lateral femoral condyle index were morphological risk factors for ipsilateral graft ruptures and contralateral ACL ruptures in children and adolescents after ACL reconstruction. Differences in outcomes between studies should be interpreted in light of the multifactorial causes for ACL (re-)ruptures, as besides to morphological factors, other intrinsic and extrinsic factors are known to be risk factors for ACL (re-)injury [[11], [23]]. As the age of onset for anterior cruciate ligament (ACL) ruptures in children decreases, the incidence of ACL ruptures in children increases [[1], [34]]. The aim of this study was to evaluate the tibiofemoral morphology of the lateral knee compartment on magnetic resonance imaging (MRI) as risk factors for ipsilateral graft rupture and contralateral ACL rupture after ACL reconstruction in children and adolescents in a case control study. [Extracted from the article]

We present the first case of an arteriovenous fistula after an all-inside anterior cruciate ligament (ACL) reconstruction. A seventeen-year-old boy had an uneventful ACL reconstruction. Four weeks after surgery, the patient was seen with a pulsating swelling at the lateral distal upper leg. Vascular consultation led to the diagnosis of pseudoaneurysm and arteriovenous fistula of the lateral superior genicular artery. Most likely, fistula is caused by the stab incision for preparation of the femoral tunnel, and no anatomical cause was found. The clinical presentation, previous cases of arteriovenous fistula after arthroscopic ACL reconstruction, possible causes, and management are discussed. [ABSTRACT FROM AUTHOR]

Specific return to sport criteria for children and adolescents after anterior cruciate ligament injury and reconstruction are unknown. The aim of this scoping review is to provide an overview of current tests regarding return to sport for children and adolescents. This scoping review was performed according to the PRISMA statement. A systematic search was performed on PubMed and EMBASE. The inclusion criteria were diagnostic and prognostic studies evaluating tests regarding return to sport after ACL injury and reconstruction in children/adolescents (age < 18 years). Twenty-six studies were included, of which 22 studies evaluated tests in the age category of 16 to 18 years. All studies evaluated tests after ACL reconstruction, no studies have been conducted in non-operative patients. Strength tests, movement quality and patient reported outcomes measures (PROMs) are investigated most frequently. Clearance for return to sport should be based on a test battery including strength tests, movement quality during sport-specific tasks and (paediatric) patient reported outcome measures. There are no recommendations on which specific tests regarding quantity and quality of movement should be used. Future research should aim at at developing and validating a test battery including movement quality and neuromotor control in a sport-specific context for both younger children and adolescents after both operative and non-operative treatment. [ABSTRACT FROM AUTHOR]