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Posterior cruciate ligament reconstruction in skeletal immature children
Ole Gade Sørensen1, Peter Faunø2, Svend Erik Christiansen2
1Department of Sportstraumatology, University Hospital of Århus, Tage Hansens Gade 2, 8000, Århus C, Denmark. olegades@hotmail.com.
Insights
Posterior cruciate ligament (PCL) reconstruction in children with open growth plates shows fair to good outcomes. Most young patients returned to sports, though one experienced leg length discrepancy.
Area of Science:
- Pediatric Orthopedics
- Sports Medicine
- Knee Ligament Injuries
Background:
- Posterior cruciate ligament (PCL) ruptures are uncommon in children with open growth plates.
- Surgical reconstruction of the PCL in skeletally immature patients is infrequently reported.
- Evaluating outcomes in this specific pediatric population is crucial for treatment guidelines.
Purpose of the Study:
- To assess the clinical outcomes of PCL reconstruction in six skeletally immature patients.
- To determine the efficacy and safety of PCL reconstruction in a pediatric cohort with open physes.
- To provide follow-up data on functional recovery and potential complications.
Main Methods:
- A cohort of six skeletally immature patients underwent PCL reconstruction between 2006 and 2010.
- Median age at surgery was 9 years, with a median follow-up of 50 months.
- Outcomes were measured using KOOS and Tegner scores, instrumented laxity testing (KT-1000), and leg length measurements.
Main Results:
- Patients reported fair to good outcomes, with median KOOS score of 88 and Tegner score of 6.
- Instrumented laxity testing showed median side-to-side differences of 2 mm (25° flexion) and 3 mm (70° flexion).
- All but one patient returned to sports; one patient developed a 16 mm leg length discrepancy.
Conclusions:
- PCL reconstruction can yield fair to good clinical results in skeletally immature children.
- While generally safe, potential complications like leg length discrepancy require monitoring.
- This study contributes valuable Level IV evidence on PCL reconstruction in pediatric patients.
Purpose:
Rupture of the posterior cruciate ligament (PCL) is a rare knee injury in children with open growth plates. The follow-up results of six patients with open physes treated with PCL reconstruction are presented. The objective is to evaluate the clinical outcomes of PCL reconstruction for six skeletally immature patients.
Methods:
Between 2006 and 2010, six skeletally immature patients were treated with PCL reconstruction. At the time of surgery, the median age was 9 years (range 6-14). The median follow-up time after surgery was 50 months (range 41-90). Outcomes were evaluated by KOOS and Tegner scores, instrumented knee laxity, and radiologic long-axis leg length measurements.
Results:
The median KOOS score at follow-up was 88 (range 26-98). The median Tegner score was 6 (range 4-7). The median side-to-side difference in laxity according to KT-1000 was 2 mm (range 1-5) at 25° of flexion and 3 mm (range 3-6) at 70° of flexion. A median side-to-side difference in flexion of 8° was found. All but one patient had returned to playing sports at follow-up. One patient's index leg had a length discrepancy of 16 mm.
Conclusions:
PCL reconstruction resulted in fair to good clinical outcomes for skeletally immature children. Clinically relevant leg length discrepancy was found in one of the six patients examined in this study.
Level Of Evidence:
Level IV.
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