title: Revision pediatric anterior cruciate ligament reconstruction after failure of iliotibial band technique treated with all-epiphyseal technique in a prepubescent with Ehlers-Danlos syndrome: a case report.
abstract: The increasing number of pediatric anterior cruciate ligament (ACL) injuries and the failure of nonoperative management of these patients has elicited a concordant response in the surgical community to devise reconstruction techniques that stabilize the knee joint without causing iatrogenic growth disturbances. Likewise, the rise in pediatric ACL reconstructions forecasts a consequent rise in revision ACL reconstructions in patients with open physes. In this case report, we describe a prepubescent with Ehlers-Danlos syndrome and congenital ACL deficiency, who underwent physeal-sparing iliotibial band ACL reconstruction and revision to an all-epiphyseal ACL reconstruction with allograft. We also underscore the lack of evidence addressing graft choice and outcomes for ACL reconstructions in patients with connective tissue disorders.
authors.affiliation: aDepartment of Orthopaedics and Sports Medicine, University of South Florida Morsani College of Medicine, Tampa bChildren's Orthopaedics and Scoliosis Surgery Associates, LLP, All Childrens Hospital/Johns Hopkins Medicine, St Petersburg, Florida, USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Erdman
authors.forename: Drew E
authors.initials: DE
authors.lastname: Warnick
mesh_terms: D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D002648:Child; D004535:Ehlers-Danlos Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery*; D004838:Epiphyses / Q000000981:diagnostic imaging; D005260:Female; D006132:Growth Plate / Q000000981:diagnostic imaging* / Q000637:transplantation*; D006801:Humans; D012086:Reoperation / Q000379:methods*; D017211:Treatment Failure