Frank A. Cordasco MD, MS is a sports medicine specialist at Hospital for Special Surgery in New York City. He said that the surgery to use an implant for graft fixing was more efficient than previous methods, and had shown to have more successful outcomes. Dr. Cordasco, along with a colleague at HSS, pediatric orthopedist Daniel W. Green MD, MS FAAP, FACS have joined forces in this endeavor and are leaders in the country in implementing the technique in the operating rooms.<\/p>\n\n\n\n
The physicians are committed to improving the outcomes of pediatric and young adolescent ACL tears through both research and education. They have been working with Arthrex for approximately 15 years and helped evaluate the device’s clinical effectiveness. Drs. Cordasco and Green also developed pediatric- and young-adolescent-specific instrumentation guides to address an increasing population of injured high-risk young athletes. Only adult instrumentation guide were used previously and they are insufficient for the surgical management of these young athletes.<\/p>\n\n\n\n
In the last two decades, tears of the ACL have become more common among children and adolescents, as the number of boys and girls participating in team sports has increased.<\/p>\n\n\n\n
However, until relatively recently, surgeons tended to avoid operating on children with unfused growth plates. According to Dr. Green, this can lead to permanent deformities in the long bones that meet at knee level (femur & tibia). In the past, most patients were treated with braces and hoped for the best. In most cases, however, this non-operative treatment led to severe problems. This included further joint damage, and also psychosocial effects, by restricting the young athlete’s participation in sports for a few more years.<\/p>\n\n\n\n
Cordasco-Green, a technique for all-epiphyseal ACL repair developed in collaboration by Arthrex is intended to be used in younger athletes who still have more than three growth years left. This technique involves using pediatric-specific instruments to drill the sockets for ACL grafts and avoid the growth plates, thereby reducing the risk of growth disruption.<\/p>\n\n\n\n
This technique is used in adolescents who are nearing skeletal maturity. This technique uses a small socket that is drilled across the growth plate to perform ACL reconstruction with a quadriceps (a piece of an athlete’s quadriceps) autograft. According to their research, Drs. Cordasco and Green found that quadriceps-based autografts had superior results compared to hamstring-based autografts for ACL reconstruction in this high-risk young athlete population.<\/p>\n\n\n\n
The new technique, unlike previous versions of the procedure, uses Adjustable-Loop-buttons instead of Fixed-Loop-buttons. This feature allows surgeons to better tension the quadriceps tendon autograft while the patient is still on the operating table, and reduces “creep”, slack tissue that can lead to residual instability of the knee. “The better the outcome is for athletes, the stronger the fixation during surgery.” said Dr. Cordasco. The implant also eliminates the requirement for ligament screw fixation which can increase the risk of growth plate injury.<\/p>\n\n\n\n
The techniques used have produced superior results in terms of revision surgery and the return to sport. “Our research shows that over 90% of the children who had this surgery at HSS returned to sports successfully without needing additional surgery,” Dr. Cordasco said.<\/p>\n\n\n\n
Dr. Green said that the ideal patient is a child aged between 12 and 16 years old, depending on the athlete’s skeletal maturity. At this age, the growth plates have effectively closed. He added that this group has experienced an “epidemic of ACL tears” over the past 20 years.<\/p>\n\n\n\n
Dr. Green has concluded that younger children are unlikely to be suitable candidates for this procedure because their bones may not have enough size to support the sockets. The youngest children can benefit from a different, physeal sparing procedure using the iliotibial bands as a graft.<\/p>\n\n\n\n The device, designed to combat an “epidemic”, of knee injuries among younger athletes who are skeletally immature, was developed by HSS surgeons and adapted for this high-risk young athlete group. The FDA has approved the ACL TightRope (r)II implant for the first time ever to reconstruct torn ligaments of knees in children and teenagers. The technology is […]<\/p>\n","protected":false},"author":1,"featured_media":148,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-54","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-news"],"_links":{"self":[{"href":"https:\/\/kurir-health.com\/index.php?rest_route=\/wp\/v2\/posts\/54","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kurir-health.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kurir-health.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kurir-health.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kurir-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=54"}],"version-history":[{"count":2,"href":"https:\/\/kurir-health.com\/index.php?rest_route=\/wp\/v2\/posts\/54\/revisions"}],"predecessor-version":[{"id":274,"href":"https:\/\/kurir-health.com\/index.php?rest_route=\/wp\/v2\/posts\/54\/revisions\/274"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kurir-health.com\/index.php?rest_route=\/wp\/v2\/media\/148"}],"wp:attachment":[{"href":"https:\/\/kurir-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=54"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kurir-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=54"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kurir-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=54"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/kurir-health.com\/wp-content\/uploads\/2023\/05\/image-17.png\")
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