title: Double-bundle anterior cruciate ligament reconstruction in a skeletally immature adolescent athlete.
abstract: We present a technique for double-bundle anterior cruciate ligament (ACL) reconstruction in a 14-year-old female athlete. The patient presented with anterolateral knee rotatory instability following a traumatic injury suffered while practicing judo. The clinical examination revealed positive Lachman and pivot shift tests with no accompanying meniscal pathology. Roentgenograms revealed open physes, and magnetic resonance imaging scans confirmed an isolated midsubstance ACL tear without cartilaginous injury. The decision was made to anatomically reconstruct the ACL because the athlete wished to continue competitive judo. Autologous hamstring tendons were harvested for double-bundle ACL repair. Following arthroscopic retrograde femoral and antegrade tibial tunnel placement, the ligaments were secured using interference screws within the femoral and tibial epiphysis. Postoperative Lachman and pivot shift tests were negative.
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
authors.forename: Gian M
authors.initials: GM
authors.lastname: Salzmann
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Spang
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
mesh_terms: D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D005269:Femur / Q000601:surgery / Q000637:transplantation; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013177:Sports; D013977:Tibia / Q000601:surgery / Q000637:transplantation; D014182:Transplantation, Autologous