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[ACL reconstruction in skeletally immature patients]
Summary
Anterior cruciate ligament (ACL) reconstruction using hamstring grafts in skeletally immature patients demonstrated excellent clinical outcomes and stability. This method showed a low complication rate, with no growth deformities observed, suggesting it as a viable treatment option.
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 treatment, but concerns exist regarding physeal preservation.
Purpose of the Study:
- To evaluate the clinical outcomes of ACL reconstruction using hamstring grafts in skeletally immature patients.
- To assess graft stability, functional recovery, and the incidence of growth-related complications.
Main Methods:
- A retrospective study of 55 skeletally immature patients undergoing ACL reconstruction with a four-strand hamstring graft.
- Anatomic transepiphyseal graft fixation with extracortical button (femoral) and suture washer/staple (tibial).
- Mean patient age at operation was 13 years (range 8-16).
Main Results:
- Mean follow-up of 3.2 years showed high functional scores (IKDC 90.7%, Lysholm 94.1, Cincinnati 93.9).
- 88% of patients returned to pre-injury sports levels (Tegner score).
- KT-1000 arthrometer showed improved stability (1.0 mm difference), with a 5.5% re-rupture rate and no growth deformities.
Conclusions:
- ACL reconstruction with hamstring grafts and extracortical fixation yields favorable clinical results in immature patients.
- This technique offers good graft stability and functional recovery.
- The complication rate is low, with no observed adverse effects on skeletal growth.
