Growth disturbances without growth arrest after ACL reconstruction in children

Knee Surg Sports Traumatol Arthrosc. 2010 Nov;18(11):1496-500. doi: 10.1007/s00167-010-1069-5. Epub 2010 Feb 25.

Abstract

Growth arrest is a major concern after ACL reconstruction in children. It usually occurs in patients near to closure of the growth plates. Growth disturbances without growth arrest are also possible and more vicious; the authors analyse the mechanism of two patients with growth disturbance due to overgrowth following ACL reconstruction. One was a symmetrical overgrowth process with 15 mm limb length discrepancy treated with percutaneous epiphysiodesis. Full correction at the time of skeletal maturity was achieved. The second patient developed an asymmetrical overgrowth with progressive tibial valgus deformity. This mechanism was similar to a posttraumatic tibial valgus deformity. After nonoperative treatment, a spontaneous correction of the deformity was noticed. Both children were young (7 and 10 years old) at the time of ACL reconstruction with an autologous iliotibial band graft. The clinical relevance of overgrowth disturbance is usually limited when compared to growth arrest but could require a second surgical procedure as reported in this study. Parents must be informed that even in experienced hands, and despite the use of a physeal sparing technique, this specific risk of growth disturbance is still present.

Publication types

  • Case Reports

MeSH terms

  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries*
  • Child
  • Follow-Up Studies
  • Growth Disorders / diagnostic imaging
  • Growth Disorders / etiology*
  • Growth Disorders / surgery
  • Growth Plate / growth & development*
  • Growth Plate / surgery
  • Humans
  • Knee Injuries / diagnosis
  • Knee Injuries / surgery
  • Leg Length Inequality / diagnostic imaging
  • Leg Length Inequality / etiology
  • Leg Length Inequality / surgery
  • Magnetic Resonance Imaging / methods
  • Male
  • Radiography
  • Reconstructive Surgical Procedures / adverse effects*
  • Reconstructive Surgical Procedures / methods
  • Reoperation
  • Risk Assessment
  • Rupture / surgery
  • Treatment Outcome