[ACL reconstruction in skeletally immature patients]

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Pediatric Orthopedics

Background:

• Anterior cruciate ligament (ACL) deficiency in skeletally immature patients presents unique treatment challenges.
• ACL reconstruction is the standard surgical intervention for restoring knee stability and function.

Purpose of the Study:

• To evaluate the clinical outcomes of ACL reconstruction in skeletally immature patients.
• To assess the efficacy and safety of hamstring grafts with extracortical fixation in this population.

Main Methods:

• A retrospective study involving 55 skeletally immature patients undergoing ACL reconstruction.
• Utilized a four-strand hamstring graft with anatomic transepiphyseal fixation (extracortical button femoral, suture washer/staple tibial).
• Mean patient age at operation was 13 years (range 8-16 years).

Main Results:

• Mean follow-up of 3.2 years revealed high functional scores (IKDC 90.7%, Lysholm 94.1, Cincinnati 93.9).
• 88% of patients returned to pre-injury sports levels (Tegner score).
• Excellent knee stability (KT-1000 arthrometer 1.0 mm) and a low re-rupture rate (5.5%) were observed; no growth disturbances occurred.

Conclusions:

• ACL reconstruction with hamstring grafts and extracortical fixation yields good clinical results in skeletally immature patients.
• This technique is a potentially preferred treatment option for pediatric ACL deficiency.
• The complication profile is favorable, with no reported growth-related complications.