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Related Experiment Videos

ACL reconstruction in children with open physes

L J Bisson1, T Wickiewicz, M Levinson

  • 1Hospital for Special Surgery, New York, NY, USA.

Orthopedics
|June 27, 1998
PubMed
Summary

This study found that anterior cruciate ligament (ACL) reconstruction in young males with open physes using hamstring grafts resulted in excellent outcomes and return to sport, with no significant physeal injury.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Pediatric Orthopedics

Background:

  • Anterior cruciate ligament (ACL) injuries are common in young athletes.
  • Reconstruction in skeletally immature patients with open physes presents unique challenges regarding physeal preservation.
  • Graft choice and surgical technique are critical for successful outcomes in this population.

Purpose of the Study:

  • To evaluate the outcomes of intra-articular ACL reconstruction using semitendinosus and gracilis tendon grafts in male patients with wide open physes.
  • To assess graft integrity, functional recovery, and potential physeal complications.
  • To determine the safety and efficacy of this technique in a pediatric and adolescent population.

Main Methods:

  • Retrospective review of nine male patients with open physes undergoing ACL reconstruction.
  • Grafts passed through the tibial physis and over the top of the femoral condyles.
  • Follow-up included clinical assessment (Lysholm score), KT-1000 arthrometer testing, and radiographic evaluation for physeal injury and limb length discrepancy.

Main Results:

  • Seven of nine patients achieved excellent results with full return to sport.
  • Mean Lysholm score was 99; mean KT-1000 difference was 2.8 mm.
  • Postoperative height increase averaged 10.7 cm, with no clinically significant leg-length discrepancy or physeal injury observed.

Conclusions:

  • Intra-articular ACL reconstruction with hamstring grafts in skeletally immature male athletes with open physes can yield excellent functional outcomes.
  • This technique appears safe regarding physeal preservation and limb length, with minimal risk of significant deformity.
  • While most grafts remained intact, graft rupture remains a potential complication that requires consideration.

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