KneeComparison of clinical outcomes between anterior cruciate ligament reconstruction with over-the-top route procedure and anatomic single-bundle reconstruction in pediatric patientsKamei, Gokia; Nakamae, Atsuoa; Nakata, Kyoheia; Nekomoto, Akinoria; Tsuji, Shunyaa; Hashiguchi, Naofumia; Ishikawa, Masakazub; Adachi, Nobuoa Author Information Departments of aOrthopaedic Surgery bArtificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Received 2 February 2022 Accepted 10 July 2022 Correspondence to Goki Kamei, PhD, MD, Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan, Tel: +81 82 257 5232; fax: +81 82 257 5234; e-mail: [email protected] Journal of Pediatric Orthopaedics B 32(2):p 178-184, March 2023. | DOI: 10.1097/BPB.0000000000001008 Buy Metrics Abstract The purpose of this study is to evaluate the clinical results of over-the-top route (OTTR) reconstruction for pediatric anterior cruciate ligament (ACL) injuries and compare them with results of anatomic single-bundle reconstruction (SBR), which used the bone tunnel technique and was performed early after epiphyseal closure (age ≤15 years). This study included pediatric patients aged 11–15 years who underwent ACL reconstruction. The mean age at surgery was 13.4 years (11–15 years), including 14 men and 29 women. Operative procedures were determined according to growth plate closure. In all cases, the tibial side was reconstructed using a bone tunnel procedure. On the femoral side, we selected the OTTR procedure (group O) with open physis. Where the physis was closed, we selected the anatomical SBR (group B). The clinical results were evaluated with manual examination, the side-to-side difference (SSD) in tibial anterior translation using the Kneelax 3, and knee function score. There were no significant differences in the Lachman and pivot-shift tests, SSD in tibial anterior translation with Kneelax 3, or knee function score between the two groups before or after the surgery. Growth disturbance was not observed on either the femoral or tibial side in group O. The OTTR method provided comparable results with the bone tunnel anatomical method in manual examination, Kneelax 3, and knee clinical function scores, suggesting that the OTTR method is very useful for pediatric ACL reconstructions. Level of evidence: III; retrospective study. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.