The outcomes after anterior cruciate ligament reconstruction in adolescents with open physes

Abstract

We evaluated the clinical outcome of anterior cruciate ligament reconstruction (ACLR) in adolescents with open physes and compared those results with adults. Fifteen adolescents with open physes underwent physeal-sparing double-bundle ACLR using hamstring autograft. The median age of the adolescents was 14 years (range 13-16 years). Forty adults underwent anatomic double-bundle ACLR during the same period of this study. The median age of the adults was 26 years (range 17-39 years). Clinical outcomes were evaluated in terms of manual Lachman test, pivot shift test and the results of KT-2000 arthrometer. Additionally, we evaluated clinical outcome in terms of International Knee Documentation Committee (IKDC) score and Lysholm Knee Scoring Scale. We also evaluated rates of re-rupture. No clinically significant growth abnormalities were observed in adolescent cases. In the Lachman test, two of the 15 adolescents had a positive, whereas one of the 40 adults had a positive (n.s.). In the pivot shift test, three of the 15 adolescents had a positive, whereas two of the 40 adults had a positive (n.s.). There was no statistically significant difference between adolescents and adults, in the mean side-to-side difference in KT-2000 measurements (1.5 ± 1.5 mm vs. 1.1 ± 1.9 mm: n.s.), the median IKDC score (96.7 vs. 97.3: n.s.) and Lysholm Scale (99 vs. 98: n.s.), rates of re-rupture (13.3 vs. 7.5 %: n.s.). Physeal-sparing ACLR with hamstring autograft in adolescents with open physes resulted in good clinical outcomes similar to those of ACLR in adults without growth abnormalities.