Sandro Kohl1, Chantal Stutz1, Sebastian Decker1, Kai Ziebarth2, Theddy Slongo2, Sufian S Ahmad1, Hendrik Kohlhof1, Stefan Eggli3, Matthias Zumstein1, Dimitrios S Evangelopoulos4. 1. Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland. 2. Division of Paediatric Trauma and Orthopaedics, Department of Paediatric Surgery, University Children's Hospital, Bern, Switzerland. 3. Sonnenhof Orthopaedic Clinics, Bern, Switzerland. 4. Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland. Electronic address: ds.evangelopoulos@gmail.com.
Abstract
BACKGROUND: Optimal therapy for anterior cruciate ligament (ACL) rupture in the paediatric population still provokes controversy. Although conservative and operative treatments are both applied, operative therapy is slightly favored. Among available surgical techniques are physeal-sparing reconstruction and transphyseal graft fixation. The aim of this study was to present our mid-term results after transphyseal ACL reconstruction. METHODS: Fifteen young patients (mean age=12.8±2.6, range=6.2-15.8 years, Tanner stage=2-4) with open physis and traumatic anterior cruciate rupture who had undergone transphyseal ACL reconstruction with unilateral quadriceps tendon graft were prospectively analyzed. All children were submitted to radiological evaluation to determine the presence of clearly open growth plates in both the distal femur and proximal tibia. Postoperatively, all patients were treated according to a standardized rehabilitation protocol and evaluated by radiographic analysis and the Lysholm-Gillquist and IKDC 2000 scores. Their health-related quality of life was measured using the SF-12 PCS (physical component summary) and MCS (mental component summary) questionnaires. RESULTS: Mean postoperative follow-up was 4.1 years. Mean Lysholm-Gillquist score was 94.0. Thirteen of the 15 knees were considered nearly normal on the IKDC 2000 score. The mean SF-12 questionnaire score was 54.0±4.8 for SF-12 PCS and 59.1±3.7 for SF-12 MCS. No reruptures were observed. Radiological analysis detected one knee with valgus deformity. All patients had a normal gait pattern without restrictions. CONCLUSION: Transphyseal reconstruction of the anterior cruciate ligament shows satisfactory mid-term results in the immature patient.
BACKGROUND: Optimal therapy for anterior cruciate ligament (ACL) rupture in the paediatric population still provokes controversy. Although conservative and operative treatments are both applied, operative therapy is slightly favored. Among available surgical techniques are physeal-sparing reconstruction and transphyseal graft fixation. The aim of this study was to present our mid-term results after transphyseal ACL reconstruction. METHODS: Fifteen young patients (mean age=12.8±2.6, range=6.2-15.8 years, Tanner stage=2-4) with open physis and traumatic anterior cruciate rupture who had undergone transphyseal ACL reconstruction with unilateral quadriceps tendon graft were prospectively analyzed. All children were submitted to radiological evaluation to determine the presence of clearly open growth plates in both the distal femur and proximal tibia. Postoperatively, all patients were treated according to a standardized rehabilitation protocol and evaluated by radiographic analysis and the Lysholm-Gillquist and IKDC 2000 scores. Their health-related quality of life was measured using the SF-12 PCS (physical component summary) and MCS (mental component summary) questionnaires. RESULTS: Mean postoperative follow-up was 4.1 years. Mean Lysholm-Gillquist score was 94.0. Thirteen of the 15 knees were considered nearly normal on the IKDC 2000 score. The mean SF-12 questionnaire score was 54.0±4.8 for SF-12 PCS and 59.1±3.7 for SF-12 MCS. No reruptures were observed. Radiological analysis detected one knee with valgus deformity. All patients had a normal gait pattern without restrictions. CONCLUSION: Transphyseal reconstruction of the anterior cruciate ligament shows satisfactory mid-term results in the immature patient.
Authors: Ian R Nelson; Jason Chen; Rebecca Love; Brent R Davis; Gregory B Maletis; Tadashi T Funahashi Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-02-09 Impact factor: 4.342