Abstract
Introduction: The place of Anterior Cruciate Ligament (ACL) reconstruction in skeletally immature patients is now well established, but in reported series the numbers are few and the follow-ups short. Also, the majority of children are aged between 14 and 16 years and the results are as good as in adults. This report includes a number of ACL reconstructions in children aged less than 12 years.
Materials & Methods: A group of twenty patients with an average age of 13.5 years were reviewed. 7 children were aged 12 or under at the time of operation. There were 17 boys and 3 girls. The follow-up ranged from 12 to 72 months (mean 37.8 months).
Reconstruction was done by a standard 4-strand hamstring technique using an endobutton proximally and a spiked washer and screw distally in the tibia.
The IKDC, Lysholm and Tegner scores were used to assess the knees pre and post-operatively. Stability was measured using the KT-1000 arthrometer.
Results: Common modes of injury were football, rugby, skiing and squash. The left side was involved in 12 patients, and the right side in 8 patients. Interval between injury and surgery ranged from 3 to 22 months with an average of 8 months. Meniscal repair was carried out in 7 out of 12 patients. The average Tegner score before injury was 7.7, before operation was 4 and at the last follow-up was 7.6. The average pre-operative Lysholm score was 54.6 compared to the post-operative score of 93. There was no incidence of angular deformity or a limb length discrepancy. There has been 1 re-rupture in a child aged 11 years 11 months at operation but no meniscal injuries. The outcome in the 6 other children aged 12 or less at the time of operation has been as good as the older children.
Conclusion: Reconstruction of the anterior cruciate ligament using a trans-physeal technique gives good results in pre-pubertal children and in adolescents.
Mr James Robb – BSCOS Honorary Secretary, Mr Geoffrey Mill – Host of the meeting, Mr Robin Paton – Editorial Secretary. Correspondence should be sent to BSCOS, c/o Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London, WC2A 3PN.
