Document Title: Aronowitz-AJSM-Mar00.shtml
Article Title: Anterior Cruciate Ligament Reconstruction In Adolescents With Open Physes
Authors: Eric R. Aronowitz MD, Theodore J. Ganley MD, Joel R. Goode MD, John R. Gregg MD, and James S. Meyer MD
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: March 2000
Volume 28, pages 168-175
Keywords: Pediatric ACL reconstruction, growth plates (epiphyses).

(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)

Comments: Aronowitz et al. describe a method for pediatric ACL reconstruction using an Achilles tendon allograft. (The procedure was only carried out in ACL-deficient children 14 years of age or more; the authors describe the procedure for determing skeletal age.) The authors found the method to be successful, with no ensuing leg-length discrepancies noted. By using soft-tissue grafting, there is no concern of the growth plates (epiphyses) being bridged, as there would be if patellar-tendon autografting had been employed. Note that all patients in this study underwent examination under anesthesia (which entails performing the manual-manipulation and drawer tests, but without the worry of muscle tenseness masking ligament tears).

ABSTRACT

The purpose of this study was to evaluate anterior cruciate ligament reconstructions performed in adolescents with open physes and a skeletal age of at least 14 years. At one center, from 1992 to 1996, 19 adolescents (ages, 11 to 15 years) with open physes and a skeletal age of at least 14 years underwent arthroscopic anterior cruciate ligament reconstruction using an Achilles tendon allograft placed through drill holes across the open physes in both the distal femur and proximal tibia. Fifteen patients returned for reevaluation at an average of 25 months postoperatively (range, 12 to 60 months); the remaining four patients were interviewed by telephone. There were no significant leg-length discrepancies or angular deformities as determined by scanograms and anteroposterior and lateral radiographs of the femur and tibia. The mean Lysholm knee score was 97 (range, 94 to 100) and the mean KT-1000 arthrometer side-to-side difference at 20 pounds of anterior force was 1.7 mm (range, 0.0 to 3.0). All patients were satisfied with the results of surgery, and 16 of 19 patients returned to the same sport they were participating in before the injury. This study demonstrates that anterior cruciate ligament reconstruction using an Achilles tendon allograft is a viable treatment option for skeletally immature patients with a skeletal age of 14 years who have sustained midsubstance tears of the anterior cruciate ligament.

To access the full text of this article, please click here.
There is no charge for viewing articles. However, a password is required.
If you do not already have a password, please e-mail Michael Frind at frind@execulink.com for one.
Prior to requesting a password, please make certain you have read the Site Terms of Use pertaining to this site.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Copyright American Journal of Sports Medicine, American Orthopaedic Society for Sports Medicine, March/April 2000. For details regarding copyright as it applies to this page, please visit the page entitled Site Terms of Use and Aspects of Copyright on this site.

This website was created for the benefit of the world's largest knee-injury community, Bob's ACL WWWBoard (also known as the Kneeboard), accessible to everyone at http://factotem.org.

Documents posted on this site serve merely as a virtual library, and are intended solely for purposes of making access to high-quality peer-reviewed medical-journal articles convenient for all users of the Kneeboard. Knee-injury patients are hereby encouraged to discuss this material with their respective medical teams.

Site Terms of Use and Aspects of Copyright

Printing Hints and Tips