[ACL reconstruction in skeletally immature patients]

Sportverletz Sportschaden. 2009 Mar;23(1):47-51. doi: 10.1055/s-0028-1109307. Epub 2009 Mar 20.
[Article in German]


Aim: The treatment of choice for skeletally immature patients with anterior cruciate ligament (ACL) deficiency is an ACL reconstruction. In a retrospective study we analysed the clinical results after ACL reconstruction in skeletally immature patients.

Material and method: In 55 immature patients the ACL was replaced with a four strand-hamstring graft in an anatomic transepiphyseal origin. The fixation was by means of an extracortical button femoral and a suture washer or staple tibial. Patient mean age at operation was 13 years (8 to 16 years).

Results: The mean follow-up was at 3.2 years (1 to 7.5 years) postoperatively. The objective IKDC 2000 score was 90.7 % normal or almost normal values. The mean Lysholm score was 94.1 points (70 - 100), the mean Cincinnati knee score was 93.9 points (76 - 100) and 88 % of the patients went back to normal or almost normal sports according to the Tegner score. Stability testing performed with the KT-1000 arthrometer was 1.0 mm (0 - 4 mm) (preoperative average 5.8 mm). The traumatic re-rupture rate was 5.5 %. In two additional cases a partial rupture of the graft was analysed by arthroscopy. Growth deformities or leg length differences were not seen in any case.

Conclusion: ACL reconstruction with hamstrings and extracortical fixation showed good results and might be the treatment of choice in immature patients. The complication rate was low and there were no postoperative growth deformities.

MeSH terms

  • Adolescent
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries*
  • Child
  • Female
  • Follow-Up Studies
  • Growth Plate / physiopathology*
  • Humans
  • Knee Injuries / surgery*
  • Male
  • Postoperative Complications / physiopathology*
  • Surgical Staplers
  • Suture Anchors
  • Sutures
  • Tendon Transfer / methods*