Interest of Additional Arthroscopic Portals in Diagnosis of Hidden Lesions of the Medial Meniscus in Pediatrics Knees With ACL Deficiency

Study Overview
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Brief Summary
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Peroperatively observative study in pediatric orthopedic center in Lyon, France. 50 pediatric patients included in this study, to improve the diagnosis of hidden lesions of the medial meniscus associated with lesions of the anterior cruciate ligament. All the patients need a reconstruction of the ACL because of chronic knee instability. All the patients underwent a multi portal arthroscopy during the ACL reconstruction : anteromedial and anterolateral and after intercondylar and posteromedial. The study consists in a peroperatively arthroscopic look, in order to diagnose lesions of the posterior horn of the medial meniscus which could be missed in MRI and anteromedial and anterolateral arthroscopy. Statistics of this lesions are used to study prevalence and diagnosis capacity of this procedures. First, the surgeon did a classic knee arthroscopy. Secondarily, he did an intercondylar portal and after a posteromedial portal.

Official Title
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Prevalence and Diagnosis of Hidden Lesions of the Posterior Horn of the Medial Meniscus in Pediatric Anterior Cruciate Ligament (ACL) Lesions : Interest of Arthroscopic Intercondylar and Posteromedial Portals

Conditions
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Chronic Knee Instability

Intervention / Treatment
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* Procedure: Arthroscopic intercondylar and posteromedial portal


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Chronic knee instability with indicated surgery reconstruction Exclusion Criteria: Pregnancy No preoperatively knee MRI Posteromedial or Intercondylar Portal Failure Social security system membership failure Refusal of consent of child or parents

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arthroscopic intercondylar and posteromedial portal<br> | Procedure: Arthroscopic intercondylar and posteromedial portal<br>* Diagnosis of lesions of the Posterior Horn of the Medial Meniscus in Arthroscopic intercondylar and posteromedial portal in addition with standard ACL reconstruction, during the same surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of hidden lesions diagnosed in Arthroscopic Posteromedial Portal and not seen in classic arthroscopic portals and Intercondylar Portal. | Diagnosis of a hidden lesion of the Posterior Horn of the Medial Meniscus in Arthroscopic Posteromedial Portal, which has not be seen in classic arthroscopic portals and Intercondylar Portal. | Day 1 (during surgery) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of hidden lesions diagnosed during the arthroscopic procedure and not seen in preoperatively MRI. | Diagnosis of a hidden lesion of the posterior horn of the medial meniscus during the arthroscopic procedure, lesion not seen in preoperatively MRI. | Day 1 (during surgery) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ACL, Hidden lesions of the medial meniscus, Chronic knee instability, Intercondylar and posteromedial arthroscopy, Arthroscopic Posteromedial and Intercondylar portal, Diagnosis capacity of hidden lesions of the medial meniscus