Anterior cruciate ligament reconstruction in children with open growth plates

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Abstract


Introduction. Anterior cruciate ligament (ACL) tears are observed in 10%–32% of all traumatic lesions of the knee joint in children. Open growth plates are a serious problem in the treatment of ACL tears. Most modern methods of ACL reconstruction use transepiphyseal channels, which go through the growth plates. This may lead to angle deformity of the knee development, limb shortening and early arthritis.

Material and methods. We observed 12 patients (11–17 years old; mean age, 13.2 years) with ACL tears with opened growth plates, who were operated on between 2006 and 2010. ACL reconstruction was performed arthroscopically using the BTB-technique and synthetic grafts DONA-M.

Results. In all cases, we achieved poor results, especially when the operation was done by BTB. We avoided shortening of the leg, but arthritis was common and progressed quickly. When we tried stabilize the joint, we achieved the reverse effect – pain in the knee, with a decreased quality of life.

Conclusion. Our results demonstrate that ACL reconstruction in children with opened growth pates is not effective; we suggest performing the procedure after the growth has finished.


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About the authors

Rustam Sh Sadykov

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: srsh@inbox.ru
MD, orthopedic and trauma surgeon of the Saratov Scientific and Research Institute of Traumatology and Orthopedics.

Viktor B Bogatov

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Email: srsh@inbox.ru
MD, PhD, professor, leading research associate of the Saratov Scientific and Research Institute of Traumatology and Orthopedics

Aleksey I Norkin

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Email: srsh@inbox.ru
MD, PhD, orthopedic and trauma surgeon of the Saratov Scientific and Research Institute of Traumatology and Orthopedics.

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Copyright (c) 2016 Sadykov R.S., Bogatov V.B., Norkin A.I.

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