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Anterior Cruciate Ligament Reconstruction In Adolescents With Open Physes

Eric R. Aronowitz, MD^*, Theodore J. Ganley, MD^*,, Joel R. Goode, MD^*, John R. Gregg, MD^* and James S. Meyer, MD

^* Department of Orthopaedic Surgery, Philadelphia, Pennsylvania
Department of Orthopaedic Surgery, Radiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

Address correspondence and reprint requests to Theodore J. Ganley, MD, Department of Orthopaedic Surgery, Children’s Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104-4399

The purpose of this study was to evaluate anterior cruciate ligament reconstructions performed in adolescents with open physes and a skeletal age of at least 14 years. At one center, from 1992 to 1996, 19 adolescents (ages, 11 to 15 years) with open physes and a skeletal age of at least 14 years underwent arthroscopic anterior cruciate ligament reconstruction using an Achilles tendon allograft placed through drill holes across the open physes in both the distal femur and proximal tibia. Fifteen patients returned for reevaluation at an average of 25 months postoperatively (range, 12 to 60 months); the remaining four patients were interviewed by telephone. There were no significant leg-length discrepancies or angular deformities as determined by scanograms and anteroposterior and lateral radiographs of the femur and tibia. The mean Lysholm knee score was 97 (range, 94 to 100) and the mean KT-1000 arthrometer side-to-side difference at 20 pounds of anterior force was 1.7 mm (range, 0.0 to 3.0). All patients were satisfied with the results of surgery, and 16 of 19 patients returned to the same sport they were participating in before the injury. This study demonstrates that anterior cruciate ligament reconstruction using an Achilles tendon allograft is a viable treatment option for skeletally immature patients with a skeletal age of 14 years who have sustained midsubstance tears of the anterior cruciate ligament.

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