{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:34:28Z","timestamp":1788978868205,"version":"build-2803163510"},"reference-count":32,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>While the rate of anterior cruciate ligament (ACL) injuries and reconstruction procedures in children and adolescents is increasing, evidence of long-term outcomes after ACL reconstruction in skeletally immature patients is still lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess the long-term survivorship from revision and reoperations and to analyze the functional results and patient-reported outcomes (PROs) in skeletally immature patients (with an open physis present at magnetic resonance imaging evaluation) who underwent ACL reconstruction with hamstrings tendon with an over-the-top (OTT) technique and a lateral extra-articular tenodesis (LET).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case series; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The database of a single institution was retrospectively searched for skeletally immature patients who underwent ACL reconstruction. Ipsilateral and\/or contralateral reoperations were recorded. Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, and Tegner Activity Level scores were collected at final follow-up. Survivorship was inspected through Kaplan-Maier method with ipsilateral ACL revision as endpoint. Differences in demographics and PROs were assessed through Student\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 43 patients (mean age at surgery, 13.3 \u00b1 1.6 years), all of whom underwent an OTT technique associated with a LET, at mean follow-up of 11.0 \u00b1 2.7 years were included. Four patients (9%) underwent revision ACL in the ipsilateral knee at a mean of 5.3 \u00b1 2.4 years after surgery, with a revision rate of 5% at 5-year and 10% at 10- and 15-year follow-ups. Four patients (9%) underwent arthroscopy for a new meniscal tear, and a further 5 patients (12%) underwent staple removal because of local discomfort. A total of 11 patients (26%) underwent \u22651 reoperation in the ipsilateral knee after a mean of 3.0 \u00b1 2.1 years; and 8 patients (19%) underwent contralateral ACL reconstruction after a mean of 3.7 \u00b1 3.0 years after surgery. Mean KOOS subscales were all above the Patient Acceptable Symptom State. Patients &lt;13 years old at surgery showed worse Lysholm (82.0 vs 94.6;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .025) and KOOS\u2013Activities of Daily Living (96.7 vs 99.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .025) compared with those \u226513 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients showed high survivorship (90% of cases) from ACL revision at long-term follow-up. Still, more than one-quarter (26%) of skeletally immature patients who underwent physeal-sparing OTT plus LET technique needed a further operation in the ipsilateral knee. Higher rate of hardware removal procedures and lower functional reported outcomes were detected in patients aged &lt;13.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251389126","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:04:45Z","timestamp":1764720285000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["High Long-term Survivorship From Revision After Physeal-Sparing \u201cOver-the-Top\u201d Anterior Cruciate Ligament Reconstruction and Lateral Tenodesis in Skeletally Immature Patients: 8- to 17-Year Follow-up"],"prefix":"10.1177","volume":"13","author":[{"given":"Alberto","family":"Grassi","sequence":"first","affiliation":[{"name":"IRCCS Istituto Ortopedico Rizzoli, 2nd Orthopaedic Department, Bologna, Italy"},{"name":"Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, Bologna University, 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