What are the major concerns regarding performing anterior cruciate ligament (ACL) reconstruction in skeletally immature patients?
Early ACL reconstruction primarily risks damaging the growing physis and inducing a growth disturbance. Describe the surgical approach in prepubescent patients vs that in adolescent patients? Theodore J. Ganley Surgical options include transphyseal, epiphyseal, and extra-articular procedures. For prepubescent and younger adolescent patients, I perform an all-epiphyseal ACL reconstruction. Epiphyseal tunnels are placed by way of a tibial docking technique and a femoral outside-in technique (Figure). This procedure avoids the physis and allows for customized tunnel placement proximally and distally. For older adolescent patients with a closing physis, I perform a transphyseal ACL reconstruction with hamstring autograft and fixation adjacent to but not at the level of the growth plates. What are the benefits of delaying ACL reconstruction? Figure: In the all-epiphyseal ACL reconstruction technique, epiphyseal tunnels are placed by way of a tibial docking and femoral outside-in technique.
Related Questions
- Who should consider arthroscopic anterior cruciate ligament (acl) reconstruction for anterior cruciate ligament - acl - tear and in what cases?
- What are the major concerns regarding performing anterior cruciate ligament (ACL) reconstruction in skeletally immature patients?
- Who should have Anterior Cruciate Ligament (ACL) Reconstruction surgery?
