Paper #62 Anatomic, physeal sparing anterior cruciate ligament reconstruction in skeletally immature patients using quadruple hamstring grafts

Abstract

Intra-substance tears of the anterior cruciate ligament, once considered rare in children and adolescents with open physes, are now being reported with increasing frequency. When a child or adolescent presents with a torn anterior cruciate ligament, the physician is faced with a treatment dilemma. The natural history of conservatively treated complete ACL tears is generally poor in skeletally immature patients. Even so, many authors still advocate a conservative approach because of the risk of iatrogenic bone growth disturbance that may be caused by surgical intervention. The purposes of this study are to describe an intra-articular ACL reconstruction technique that follows the generally accepted principles of ACL reconstruction in adults, but theoretically minimizes the risk of physeal injury by not transgressing either the tibial or femoral physis; and to determine the results of this technique using quadruple hamstring ACL reconstruction for children and adolescents who have open femoral and tibial physes.