Follow-up study on transphyseal ACL reconstruction in Irish adolescents with no cases of leg length discrepancy or angular deformity.

Abstract

The rate of ACL injury in adolescents has been rising in recent years. Surgical options include transphyseal and physeal-sparing ACL reconstruction. In this study, we performed a transphyseal ACL reconstruction and followed up patients to assess functional outcomes and to assess for growth disturbance. There were 22 patients seen at follow-up between the age of 12 and 16. Skeletal age assessment was performed using an MRI atlas with an average skeletal age of 14.7 (range 12-16). The mean follow-up time was 36months (range 14-63months). Clinical examination was performed to assess for leg length discrepancy, and leg length radiographs were used to assess for angular deformity. Patients' post-surgery functionality was assessed with the IKDC score and the Tegner Lysholm score. The mean IKDC and Lysholm scores at follow-up were found to be 91 and 94, respectively. The median Tegner score prior to injury was 8.5 and postoperatively was 7.5. There were no cases of leg length discrepancy found on clinical examination, and there were no cases of significant angular deformity. Four patients ruptured again and went on to have repeat ACL reconstruction. Midterm results at an average follow-up of 3years after the surgery showed good functional outcomes using the transphyseal ACL reconstruction technique with good return to activity. There were no cases of leg length discrepancy or angular deformity. Transphyseal ACL reconstruction is a viable method of treatment for adolescent ACL tears.