{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:37:33Z","timestamp":1792093053223,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T00:00:00Z","timestamp":1549238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T00:00:00Z","timestamp":1549238400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T00:00:00Z","timestamp":1549238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"funder":[{"name":"L.T. Staheli Endowment"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the effect of transphyseal anterior cruciate ligament (ACL) reconstruction on lower extremity radiographic growth and alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients who underwent transphyseal ACL reconstruction and were followed to skeletal maturity or at least 2\u00a0years, with the nonoperative limb used as an internal control. Changes in coronal plane alignments and tibial slope of the operative limb were compared with a Wilcoxon test. Associations among sex, tunnel, and graft characteristics and failure; changes in coronal plane measures and tunnel size; and tunnel angles and the development of deformity were examined by \u03c7\u2010square and correlation coefficients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010nine patients (41 boys and 18 girls) underwent surgery at a mean age of 12.5\u00a0years (range, 6.8\u201016.0\u00a0years). There were differences in changes in the mechanical lateral distal femoral angle comparing operative and nonoperative limbs (decreased 1.1\u00b0 in girls and 1.9\u00b0 in boys \u226413\u00a0years of age,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .0008 and .025, respectively) and in changes in tibial slope of the operative limb (decreased 2.1\u00b0 in male patients &gt;13\u00a0years,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .012). No patient developed a new limb length difference &gt;1\u00a0cm. Two boys were treated for deformities. Eight additional patients developed &gt;5\u00b0 difference in alignment for a rate of radiologic deformity of 10 of 59 or 17%. Neither graft failure nor the presence of deformity was associated with sex, tunnel size, mode of femoral tunnel positioning, inclination of tunnels, or the use of allograft.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Radiographically evident limb deformities following transphyseal ACL reconstruction occurred at a rate of 17%, although these deformities were clinically evident in only 5% of patients. Tunnels intersecting physes near cortical margins may increase the risk of developing deformity. Regular follow\u2010up should include alignment radiographs to detect deformities despite the clinical appearance of neutral limb alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, case\u2010control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2018.10.132","type":"journal-article","created":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T00:14:52Z","timestamp":1549239292000},"page":"940-949","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Impact of Transphyseal Anterior Cruciate Ligament Reconstruction on Lower Extremity Growth and Alignment"],"prefix":"10.1002","volume":"35","author":[{"given":"Ahmad F.","family":"Bayomy","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine Seattle Children's Hospital Seattle Washington U.S.A."},{"name":"Department of Orthopaedics &amp; Sports Medicine University of Washington School of Medicine Seattle Washington U.S.A."},{"name":"Department of Orthopedic Surgery Columbia University Children's Hospital of New York\u2013Presbyterian New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviana","family":"Bompadre","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine Seattle Children's Hospital Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Schmale","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine Seattle Children's Hospital Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,4]]},"reference":[{"key":"e_1_2_3_2_2","unstructured":"National Federation of State High School Associations.High School sports participation increases for 27th consecutive yearhttps:\/\/nfhs.org\/articles\/high\u2010school\u2010sports\u2010participation\u2010increases\u2010for\u201027th\u2010consecutive\u2010year\/. 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