Abstract
Anterior Cruciate Ligament (ACL) injuries are increasing in prevalence amongst younger patients. Concerns exist as to the possibility of growth impairment due to transphyseal reconstruction techniques. However, due to the poor results of conservative treatment, reconstructive procedures have been employed to improve the outcome of these injuries. A growing body of evidence supports the safety of transphyseal reconstruction in older children. This study evaluates the safety and results of these techniques in younger patients.
Between 1999 and 2006, 17 patients of Tanner stage 1 or 2 underwent unilateral transphyseal ACL ligament reconstruction, using ipsilateral, four-strand hamstring grafts. Patients were aged between 9.5–14.0 years (mean, 12.1 years), and were followed up for a minimum of two years and a mean of 44 months (range 25–100 months). Graft survival, functional outcome and complications were recorded.
There was one graft failure after re-injury (6%). Of the remaining patients, all reported a good or excellent result and a normal IKDC score. Mean postoperative Lysholm score was 97.5 ± 2.6, mean Tegner activity scale was 8.1 ± 0.8 pre-injury, 4.2 ± 1.0 post-injury, and 7.9 ± 1.4 post-operatively. One patient had mild valgus deformity which caused no functional disturbance; otherwise examination was normal in all patients. There were no leg length discrepancies and KT1000 arthrometer measurements showed no significant difference between normal and operated legs.
Based on the results of this series, transphyseal reconstruction appears to be a safe option for the treatment of anterior cruciate ligament injuries in the young child.
Correspondence should be addressed to Editorial Secretary Mr ML Costa or Assistant Editorial Secretary Mr B.J. Ollivere at BOA, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England; Email: mattcosta@hotmail.com or ben@ollivere.co.uk
