KNEE UPDATE 

Minerva Ortopedica e Traumatologica 2011 June;62(3):199-207

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

ACL reconstruction in the skeletally immature patients

Drew O. R., Alan Barber F.

Plano Orthopedic Sports Medicine and Spine Center, Plano, TX, USA

The increase in younger athletes participating in year-round pivoting and contact sports has lead to an increase in knee injuries. These traumatic and non-traumatic injuries frequently include anterior cruciate ligament injuries. A distinct group of these young patients present an exceptional challenge: those who are skeletally immature. Treatment of anterior cruciate ligament (ACL) tears in skeletally immature patients is challenging. Delayed reconstruction is unsatisfactory because of the lack of success in effectively restricting pivoting activities in this age group. ACL reconstruction after the appropriate initial rehabilitation has been shown to be consistently successful with little risk of growth disturbance if fixation devices or bone plugs do not cross the growth plates. Nonetheless, a preoperative evaluation for leg-length discrepancy or angular deformity is appropriate to document existing abnormalities. ACL techniques using standard tunnel positions and passing a soft-tissue graft across the existing growth plates are successful.