J Korean Med Sci.  2005 Dec;20(6):1034-1038. 10.3346/jkms.2005.20.6.1034.

Transphyseal Reconstruction of the Anterior Cruciate Ligament Using Hamstring Autograft in Skeletally Immature Adolescents

• Seon JK
• Song EK
• Yoon TR
• Park SJ

• KMID: 2157758
• DOI: http://doi.org/10.3346/jkms.2005.20.6.1034

Abstract

Eleven skeletally immature adolescents underwent anterior cruciate ligament reconstruction using a transphyseal tibial and femoral tunnel. An autologous quadrupled hamstring tendon was used in all cases and the average follow-up was 77.7 months. Clinical results were evaluated using Lysholm knee scores and a return to pre-injury sports activities. Radiological results were evaluated using side-to-side differences of instrumented laxities and growth disturbances compared with the uninjured side on final follow-up orthoroentgenograms. The mean Lysholm score was 97.8 (range 94-100) and mean side-to-side laxity difference was 2.4 mm (range 1-4). Ten of 11 patients returned to pre-injury sports activity. No patient had a leg length discrepancy of over 1 cm or a significant abnormal angular deformity of the knee joint. Therefore, anterior cruciate ligament reconstruction using the transphyseal tunnel and hamstring autograft in skeletally immature adolescents is believed to be a reliable treatment method, which is not associated with significant leg length discrepancy or abnormal angular deformity of the knee joint.

Keyword

Adolescent; Anterior Cruciate Ligament; Reconstructive Surgical Procedures

MeSH Terms

Adolescent
Anterior Cruciate Ligament/*injuries/radiography/*surgery
Bone Development
Growth Plate/injuries/radiography/surgery
Humans
Knee Injuries/radiography/surgery
Male
Orthopedic Procedures/*methods
Tendons/transplantation
Transplantation, Autologous

Figure

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  Fig. 1 Roentgenograms of a young patient with a "wide open" skeletally immature physes (A) and of a young patient with a "closing" skeletally mature physes (B).

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  Fig. 2 Assessment of the knee alignment by using femorotibial angle (A), anatomical lateral distal femoral angle (B), mechanical lateral distal femoral angle (C), mechanical medial proximal tibial angle (D), and posterior distal femoral and posterior proximal tibial angles (E).

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  Fig. 3 Anteroposterior (A) and lateral (B) radiograms, and an orthoroentgenogram (C) of a 21-yr-old male at 7 yr 5 months postoperatively showing a closed physes and no angular deformity or leg length discrepancy compared with the uninjured right side.

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