BACKGROUND: The evidence in favor of early surgical treatment of anterior cruciate ligament (ACL) injuries in children is increasing. However, the controversy regarding the safety of such a procedure in young athletes with wide open physes remains unresolved. METHODS: We reviewed prospectively collected outcome data on consecutive patients who had undergone transphyseal ACL reconstruction at either (1) an age of less than fourteen years and Tanner stage 1 or 2, or (2) an age of less than twelve years and Tanner stage 3. Children who had less than four years of follow-up, who were younger than sixteen years at the time of final follow-up, or who had been at Tanner stage 4 at the time of surgery were excluded. Twenty-eight of the thirty-two included patients had been at Tanner stage 1 or 2 at the time of surgery, and the remaining four had been at Tanner stage 3 but had been younger than twelve years of age. The mean age at the time of the surgery was 11.25 years (range, 9.5 to 14.0 years; median, 12.1 years). The mean duration of follow-up was 72.3 months (range, forty-eight to 129 months; median, seventy-two months). RESULTS: The mean Lysholm score improved from 71.5 preoperatively to 95.86 postoperatively (p < 0.0001). The mean Tegner activity scale score improved from 4.03 to 7.66 (p < 0.0001), which was comparable with the preinjury score of 8.0. One patient had a mild valgus deformity with no functional disturbance, and none had a limb-length discrepancy. One rerupture occurred, but all other patients had a good or excellent outcome. CONCLUSIONS: This case series indicates good long-term results of ACL reconstruction with use of a transphyseal technique in young children.
BACKGROUND: The evidence in favor of early surgical treatment of anterior cruciate ligament (ACL) injuries in children is increasing. However, the controversy regarding the safety of such a procedure in young athletes with wide open physes remains unresolved. METHODS: We reviewed prospectively collected outcome data on consecutive patients who had undergone transphyseal ACL reconstruction at either (1) an age of less than fourteen years and Tanner stage 1 or 2, or (2) an age of less than twelve years and Tanner stage 3. Children who had less than four years of follow-up, who were younger than sixteen years at the time of final follow-up, or who had been at Tanner stage 4 at the time of surgery were excluded. Twenty-eight of the thirty-two included patients had been at Tanner stage 1 or 2 at the time of surgery, and the remaining four had been at Tanner stage 3 but had been younger than twelve years of age. The mean age at the time of the surgery was 11.25 years (range, 9.5 to 14.0 years; median, 12.1 years). The mean duration of follow-up was 72.3 months (range, forty-eight to 129 months; median, seventy-two months). RESULTS: The mean Lysholm score improved from 71.5 preoperatively to 95.86 postoperatively (p < 0.0001). The mean Tegner activity scale score improved from 4.03 to 7.66 (p < 0.0001), which was comparable with the preinjury score of 8.0. One patient had a mild valgus deformity with no functional disturbance, and none had a limb-length discrepancy. One rerupture occurred, but all other patients had a good or excellent outcome. CONCLUSIONS: This case series indicates good long-term results of ACL reconstruction with use of a transphyseal technique in young children.
Authors: Jason B Smoak; Alexander Macfarlane; Melissa A Kluczynski; Michael R Ferrick; Jeremy P Doak; Leslie J Bisson; John M Marzo Journal: Skeletal Radiol Date: 2019-12-17 Impact factor: 2.199