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 Vol. 19 No. 5, May 2008
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AAP Grand Rounds 19:54-55 (2008)
© 2008 American Academy of Pediatrics

ORTHOPAEDICS

Is ACL Surgery Effective for Skeletally Immature Adolescents?

Source: Kocher MS, Smith JT, Zoric BJ, et al. Transphyseal anterior cruciate ligament reconstruction in skeletally immature pubescent adolescents. J Bone Joint Surg Am. 2007;89(12):2632–2639; doi 10.2106/JBJS.F.01560[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: Among adolescents with significant anterior cruciate ligament (ACL) injury, can a modified surgical approach that limits physeal reconstruction result in acceptable knee function without causing a growth disturbance?

Question Type: Intervention

Study Design: Retrospective case series

 

Management of anterior cruciate ligament (ACL) injuries in skeletally immature patients is controversial. In a retrospective case series from Children’s Hospital, Boston, researchers evaluated the outcome of transphyseal reconstruction of the ACL in adolescents with a complete ACL tear. The study population consisted of 59 patients who underwent similar surgical repairs between 1996 and 2004.

The procedure was an arthroscopically assisted transphyseal reconstruction of the ACL with use of an autogenous quadrupled hamstrings-tendon graft through bone tunnels that cross the femoral and tibial physes with metaphyseal fixation. Outcome measures included physical examination for limb length discrepancy, physical measures of knee laxity, and two functional outcome instruments. Angular deformity and growth arrest were evaluated by postoperative radiographs.

. . . [Full Text of this Article]

Richard M. Schwend, MD, FAAP
Pediatric Orthopaedics, Children’s Mercy Hospital, Kansas City, MO

 





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