[Anterior cruciate ligament plasty in patients with open physis]

Anterior cruciate ligament lesions are common in adults but they are seldom diagnosed in adolescents. Most are due to movements or trauma resulting from physical activity. While in adults these lesions occur in the middle portion of the ligament, where it splits from the bone, and they heal by themselves, in children and adolescents they involve a higher chance of avulsion of a bone fragment, may not heal, and may warrant reduction. Arthroscopy is the most reliable means to visually detect and directly manipulate the lesion. In children and adolescents ACL lesions also occur with damage to the meniscus and result in arthritis in the adult age. Surgery, therefore, is necessary to fully restore knee function, but treatment is controversial given that the physis is open and growth arrest may occur. This paper describes an arthroscopic ACL reconstruction technique in patients with open physes that assures the sparing of the epiphysis, which avoids the risk of disrupting cartilage growth.