Rupture of the anterior cruciate ligament in children: early reconstruction with open physes or delayed reconstruction to skeletal maturity?

The purpose of this study was to compare two different strategies of management for ACL rupture in skeletally immature patient. In group 1, patients were treated in a children hospital by ACL reconstruction with open physis. In group 2, patients were treated in an adult hospital by delayed reconstru...

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Published inKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 17; no. 7; pp. 748 - 755
Main Authors Henry, Julien, Chotel, Franck, Chouteau, Julien, Fessy, Michel Henri, Bérard, Jérôme, Moyen, Bernard
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer-Verlag 01.07.2009
Springer Nature B.V
Springer Verlag
Subjects
Adolescent
Age Determination by Skeleton
Anterior Cruciate Ligament - physiopathology
Anterior Cruciate Ligament Injuries
Athletic Injuries - surgery
Bioengineering
Bone Development
Child
Child, Preschool
Female
Humans
Knee
Life Sciences
Male
Medicine
Medicine & Public Health
Orthopedic Procedures - methods
Orthopedics
Retrospective Studies
Rupture - etiology
Rupture - surgery
Tendons - transplantation
Time Factors
Treatment Outcome
Reconstruction
Meniscus
Delayed
Surgery
Adolescent
Skeletally immature
Children
Anterior cruciate ligament
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Summary:The purpose of this study was to compare two different strategies of management for ACL rupture in skeletally immature patient. In group 1, patients were treated in a children hospital by ACL reconstruction with open physis. In group 2, patients were treated in an adult hospital by delayed reconstruction at skeletal maturity assessed radiologically. Fifty-six consecutive patients were included in this retrospective study. Mean time from injury to surgery in group 1 and 2 was, respectively, 13.5 and 30 months. Patients from group 2 exhibited a higher rate of medial meniscal tears (41%) compare to group 1 (16%) and higher rate of meniscectomy. Both groups had the same rate of lateral meniscal tears. A temporary tibial valgus deformity was reported which was subsequently spontaneously resolved. No definitive growth disturbance was noticed. At 27 months mean follow-up, a best subjective IKDC score was found in group 1. Objective IKDC and radiological results were similar in both groups. Early ACL reconstruction is therefore a recommended option.
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ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-009-0741-0