Kumar, J Bone Joint Surg Am 2013 - Transphyseal Anterior Cruciate Ligament Reconstruction in the Skeletally Immature

Transphyseal Anterior Cruciate Ligament Reconstruction in the Skeletally Immature

Kumar, Hunt, et al.·J Bone Joint Surg Am·2013·109 citations·Case series

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 14 years and Tanner stage 1 or 2, or (2) an age of less than 12 years and Tanner stage 3.
Children who had less than 4 years of follow-up, who were younger than 16 years at the time of final follow-up, or who had been at Tanner stage 4 at the time of surgery were excluded.
28 of the 32 included patients had been at Tanner stage 1 or 2 at the time of surgery, and the remaining 4 had been at Tanner stage 3 but had been younger than 12 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, 48 to 129 months; median, 72 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.

Supplemental

Transphyseal Anterior Cruciate Ligament Reconstruction in the Skeletally Immature

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Transphyseal Anterior Cruciate Ligament Reconstruction in the Skeletally Immature

Kumar, Hunt, et al.·J Bone Joint Surg Am·2013·109 citations·Case series

DOI·PubMed

Background

Methods

We reviewed prospectively collected outcome data on consecutive patients who had undergone transphyseal ACL reconstruction at either (1) an age of less than 14 years and Tanner stage 1 or 2, or (2) an age of less than 12 years and Tanner stage 3.
Children who had less than 4 years of follow-up, who were younger than 16 years at the time of final follow-up, or who had been at Tanner stage 4 at the time of surgery were excluded.
28 of the 32 included patients had been at Tanner stage 1 or 2 at the time of surgery, and the remaining 4 had been at Tanner stage 3 but had been younger than 12 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, 48 to 129 months; median, 72 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

Methods

We reviewed prospectively collected outcome data on consecutive patients who had undergone transphyseal ACL reconstruction at either (1) an age of less than 14 years and Tanner stage 1 or 2, or (2) an age of less than 12 years and Tanner stage 3.
Children who had less than 4 years of follow-up, who were younger than 16 years at the time of final follow-up, or who had been at Tanner stage 4 at the time of surgery were excluded.
28 of the 32 included patients had been at Tanner stage 1 or 2 at the time of surgery, and the remaining 4 had been at Tanner stage 3 but had been younger than 12 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, 48 to 129 months; median, 72 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

Methods

We reviewed prospectively collected outcome data on consecutive patients who had undergone transphyseal ACL reconstruction at either (1) an age of less than 14 years and Tanner stage 1 or 2, or (2) an age of less than 12 years and Tanner stage 3.
Children who had less than 4 years of follow-up, who were younger than 16 years at the time of final follow-up, or who had been at Tanner stage 4 at the time of surgery were excluded.
28 of the 32 included patients had been at Tanner stage 1 or 2 at the time of surgery, and the remaining 4 had been at Tanner stage 3 but had been younger than 12 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, 48 to 129 months; median, 72 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.