Related Experiment Video
Updated: Feb 18, 2026
Surgical Retrieval, Isolation and In vitro Expansion of Human Anterior Cruciate Ligament-derived Cells for Tissue Engineering Applications
Published on: April 30, 2014
Complications associated with the techniques for anterior cruciate ligament reconstruction in patients under 18 years
W Tovar-Cuellar1, F Galván-Villamarín1, J Ortiz-Morales1
1Unidad de Ortopedia, Departamento de Cirugía, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Insights
Anterior cruciate ligament (ACL) reconstruction in skeletally immature patients showed low growth complications. Physeal-sparing techniques were linked to more length discrepancy and axis deviation compared to other methods.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Sports medicine
Background:
- Anterior cruciate ligament (ACL) injuries are common in young athletes.
- Reconstruction techniques in skeletally immature patients require careful consideration of growth plate involvement.
- Complications such as limb length discrepancy and axis deviation are potential concerns.
Purpose of the Study:
- To systematically review and determine complications associated with different anterior cruciate ligament reconstruction techniques in patients under 18 years old.
- To compare the incidence of specific complications across various surgical approaches.
Main Methods:
- Systematic review of Medline, Cochrane Database of Systematic Reviews, and Embase.
- Inclusion of studies from reference lists of previous research.
- Search terms focused on ACL reconstruction, immature patients, and growth-related complications.
Main Results:
- 73 studies involving 1300 patients (average age 13) were analyzed.
- Low overall rates of length discrepancy (0.8%) and axis deviation (1.4%) were observed.
- Physeal-sparing techniques showed a higher percentage of length discrepancy and axis deviation compared to transphyseal techniques.
Conclusions:
- Anterior cruciate ligament reconstruction in patients under 18 has low rates of growth-related complications.
- Physeal-sparing techniques may be associated with increased risks of length discrepancy and axis deviation.
- Further high-level evidence is needed to establish causality.
Objective:
Determine the complications related to the different techniques for anterior cruciate ligament reconstruction in patients under 18 years old.
Methodology:
Systematic review using the databases Medline, Cochrane Database of Systematic Reviews and Embase (until July 2016), additional studies were included conducting a search of the references of previous studies. The terms included in the search were: «cruciate», «ligament», «anterior», «immature», «complications», «outcome», «acl reconstruction»,« cruciate ligament anterior reconstruction», «children», «child», «infants», «adolescent», «open physis», «growth plate» and «skeletally immature».
Results:
A number of 73 studies were included; 1300 patients in total, average age 13 years, 70% were male, medial and lateral meniscal lesions in 26% and 30% respectively. Eleven cases of length discrepancy (0,8%): 4 cases were presented with physeal-sparing techniques (1,4%), 3 cases with partial physeal-sparing techniques (2.2%) and 4 cases were presented with transphyseal techniques (0.4%). There were 22 cases of axis deviation: 6 cases with physeal-sparing techniques (2%), 3 cases with partial physeal-sparing techniques and 13 cases with transphyseal techniques (1.4%). The use of allograft achilles tendon allograft and fascia lata was associated with increased length discrepancy and axis deviation (25%). There was no difference according to Tanner.
Conclusions:
The different anterior cruciate ligament reconstruction techniques in patients under 18 years old had low complications related to lower limb growth, arthrofibrosis and review. There was a higher percentage of cases of length discrepancy and axis deviation with physeal-sparing techniques than with the other surgical techniques. The evidence level studies cannot determine causality.
More Related Videos
05:44Author Spotlight: Double Posteromedial Approach for Treating Posterior Cruciate Ligament Cysts
Published on: October 20, 2023
05:07Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024