Aichroth, J Bone Joint Surg Br 2002 - The Natural History and Treatment of Rupture of the Anterior Cruciate Ligament in Children and Adolescents

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The Natural History and Treatment of Rupture of the Anterior Cruciate Ligament in Children and Adolescents

Aichroth, Zorrilla, et al.·J Bone Joint Surg Br·2002·318 citations·Retrospective cohort

A total of 60 children and adolescents with rupture of the anterior cruciate ligament (ACL) was seen between 1980 and 1990. Observation of the 23 patients who were treated conservatively revealed that the natural history of the injury resulted in severe instability and poor function of the knee. Associated meniscal tears were present in 15 knees. 3 osteochondral fractures occurred and osteoarthritic changes developed in 10 knees. In 1990 therefore we introduced reconstruction of the ACL with a 4-strand hamstring graft using an anatomical placement with transphyseal tunnels and anchorage well away from the growth plate. Over a period of 9 years, 47 knees underwent reconstruction. The mean follow-up was 49 months (12 to 96). No child suffered physeal damage or leg-length discrepancy. The results were satisfactory in 77% and there was little difference between patients treated before the adolescent growth spurt and those treated during or after this time. These results, however, were not as good as those seen in adults during the same period.

Copyright remains with the authors and publisher.

The Natural History and Treatment of Rupture of the Anterior Cruciate Ligament in Children and Adolescents

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The Natural History and Treatment of Rupture of the Anterior Cruciate Ligament in Children and Adolescents

Aichroth, Zorrilla, et al.·J Bone Joint Surg Br·2002·318 citations·Retrospective cohort

A total of 60 children and adolescents with rupture of the anterior cruciate ligament (ACL) was seen between 1980 and 1990. Observation of the 23 patients who were treated conservatively revealed that the natural history of the injury resulted in severe instability and poor function of the knee. Associated meniscal tears were present in 15 knees. 3 osteochondral fractures occurred and osteoarthritic changes developed in 10 knees. In 1990 therefore we introduced reconstruction of the ACL with a 4-strand hamstring graft using an anatomical placement with transphyseal tunnels and anchorage well away from the growth plate. Over a period of 9 years, 47 knees underwent reconstruction. The mean follow-up was 49 months (12 to 96). No child suffered physeal damage or leg-length discrepancy. The results were satisfactory in 77% and there was little difference between patients treated before the adolescent growth spurt and those treated during or after this time. These results, however, were not as good as those seen in adults during the same period.

Copyright remains with the authors and publisher.

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