Pediatrics News

The most recent CDC data show an estimated 329,290 children were treated in United States for sports and recreation-related injuries that included a diagnosis of concussion or traumatic brain injury.

Pediatric sports- and recreation-related traumatic brain injuries, or SRR-TBIs, cause more than 280,000 visits to EDs throughout the United States, according to researchers from the CDC. Nearly half of these SRR-TBIs are caused by contact sports.

There is no question in my mind that the ideal ACL graft for an active older patient who is uncomfortable with an allograft is a quadrupled semitendinosus autograft. By quadrupling the tendon, sufficient size and strength of the graft can be achieved. The fact that the quadrupled graft may be shorter can easily be accommodated by using an all-inside technique with bony sockets. With the harvesting of only a single hamstring, the risk of harvest morbidity is low and there is little early postoperative pain. This allows early weight-bearing and shorter time on crutches, which should decrease the risk of deep vein thrombosis or falls. The harvesting is relatively straightforward and can be performed quickly without a tourniquet. Any resulting minor hamstring weakness is unlikely to be noticed in these patients. With respect to concerns about graft retear, because the risk of ACL graft retear declines with age, as much as 50% for each decade of life, retear rates should be low. There is a reason hamstring grafts are the most commonly used grafts for ACL reconstruction worldwide and the benefits of this graft choice are amplified in the older population. In addition, any potential downsides of hamstring graft use are minimized in this age group.

The ACL is reportedly one of the most commonly injured knee ligaments among professional- and recreational-level athletes, with a high risk for primary and secondary ACL injuries found with participation in pivoting and cutting sports, such as football, basketball, skiing and soccer.

LAS VEGAS — Pediatric and adolescent patients who underwent meniscal repair with concomitant ACL reconstruction experienced a high overall clinical success rate at long-term follow-up, according to results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

LAS VEGAS — Continued curve progression can be expected in female pediatric patients with adolescent idiopathic scoliosis after they reach Sanders Stage 7 of maturity, according to results presented at the American Academy of Orthopaedic Surgeons Annual Meeting, here.

The American Academy of Orthopaedic Surgeons Annual Meeting will get underway on March 12. My first AAOS Annual Meeting was in 1988 in Atlanta. Since then, I have only missed one AAOS Annual Meeting. I am probably among the most consistent attendees at that meeting as this is my 30th time to participate in the meeting.

Temporary impairments in health-related quality of life correlated with sports-related concussions in adolescents compared with sports-related extreme fractures; however, impairments resolved in patients who were followed until physician-documented clinical recovery, according to a recently published study.

Despite a stable rate of take-home opioid prescriptions to pediatric patients undergoing outpatient surgery, results published in Pain Medicine showed a steady decline in the duration of treatment and the amount per dose from 2013 to 2017.

When parents are faced with a decision regarding the optimal treatment for their child with an ACL injury, they commonly ask, “If this was your child, what would you do?” For most, the answer is easy. We want the best surgeon to decide the best treatment that has the best outcome and the least probability of a complication. Interestingly, the paucity of high-level evidence in this area does not support the general consensus of pediatric sports medicine experts. The pendulum continues to swing as historical dogma in the treatment of pediatric ACL injuries was to delay until skeletal maturity. However, recent advances in techniques have suggested a safe alternative is early surgical treatment of ACL injuries.