Anterior cruciate ligament reconstruction in adolescents (Tanner stages 2 and 3)

Francesco Falciglia, Alfredo Schiavone Panni, Marco Giordano, Angelo Gabriele Aulisa, Vincenzo Guzzanti

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Abstract

Purpose: Management of anterior cruciate ligament injuries in skeletally immature patients (in Tanner stages 2 and 3) is controversial. Conventional reconstruction used in adults can cause iatrogenic growth disturbance due to physeal damage, and studies that report long-term results using a specific technique are scarce. The aim of this study is to evaluate in a large series the mid- and long-term results of a partial transphyseal technique and define the safe percentage of lesions of the femoral growth plate. Methods: Between 1989 and 2012, 42 adolescents at risk of growth disturbances (growth prediction of lower limbs >5 cm—Tanner 2, 3) underwent reconstruction of the anterior cruciate ligament using the semitendinosus and gracilis tendons. Growth characteristics of all the patients were assessed preoperatively, and the percentage of damage that would be produced in the femoral physis by the drilling of a 6-mm-diameter tunnel was determined. The technique used achieved graft fixation at both insertion sites, drilling the femoral physis and avoiding the tibial physis. We distinguished two groups: (a) long-term follow-up (mean 13 years 7 months, min 10.9, max 16.2) and (b) medium follow-up (mean 6 years 3 months, min 3.7, max 9.9). All knees were evaluated subjectively by history and objectively by KT2000 testing, and X-rays of both knees were compared for osteoarthritis using the Kellgren–Lawrence classification. Results: In group A (12 patients) one osteoarthritis grade 2, one instability, and ten good stability and function were observed. The mean KT2000 arthrometer values at 30 lb showed a difference of +2.4 mm (range 1–4 mm) between the operated and non-operated sides (p 

Original languageEnglish
Pages (from-to)807-814
Number of pages8
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume24
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

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Keywords

  • ACL reconstruction
  • Adolescents in Tanner stages 2, 3
  • Growth plate

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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