Transepiphyseal reconstruction of the anterior cruciate ligament in skeletally immature athletes: an MRI evaluation for epiphyseal narrowing.

Reconstructive surgery for anterior cruciate ligament (ACL) injury in skeletally immature athletes presents various clinical problems, because the reconstructive route penetrating both the femoral and tibial physes might cause their growth arrest. Anatomical changes in the physes after ACL reconstruction have not yet been clarified using MRI. Intra-articular ACL reconstructions using femoral and tibial bone tunnels were performed in 10 skeletally immature athletes, who sustained midsubstance ACL tears. The physes of the surgically reconstructed knee and the contralateral knee were compared using MRI obtained 6 months postoperatively. Plain radiography was used to determine the extent of ossification in the tunnel walls. In all patients, MR imaging showed narrowing of the growth plates in the reconstructed knee in comparison with that in the contralateral knee. Radiographic analyses showed corticalization around the drill holes in all cases. Although ACL reconstruction caused narrowing or the early closure of the open physes in adolescents, the patients did not experience limb-length discrepancies and angular deformities.