title: Good surgical outcome of transphyseal ACL reconstruction in skeletally immature patients using four-strand hamstring graft.
abstract: OBJECTIVE
  Our purpose was to evaluate the clinical and radiological outcome at maturity of an « adult-like » transphyseal anterior cruciate ligament (ACL) reconstruction performed in skeletally immature patients using four-strand hamstring graft.
  
  
  METHODS
  The records of all skeletally immature patients who underwent transphyseal ACL reconstruction between 2004 and 2006 at our institution were reviewed. Inclusion criteria were age less than 16 years and radiographic evidence of open physes. Thirty-eight children and prepubescents were identified. All underwent postoperative clinical evaluation with International Knee Documentation Committee scores and long leg radiographs. Each patient was followed up until skeletal maturity was confirmed.
  
  
  RESULTS
  Twenty-eight patients were scored A, four B, and five D according to IKDC. At last follow-up, there was no radiographic evidence of malalignment in any of the patients. Five underwent a reoperation. Three patients suffered traumatic graft disruption and two from post-operative knee instability.
  
  
  CONCLUSIONS
  Early operative treatment by means of the quadruple hamstring free graft appears to be a safe and relevant procedure for ACL reconstruction even in skeletally immature patients.
authors.affiliation: Department of Orthopedic Surgery, Grenoble University Hospital, BP 217 Cedex, Grenoble, France. aurelien.courvoisier@gmail.com
authors.forename: Aurélien
authors.initials: A
authors.lastname: Courvoisier
authors.forename: Mathieu
authors.initials: M
authors.lastname: Grimaldi
authors.forename: Stéphane
authors.initials: S
authors.lastname: Plaweski
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods; D002648:Child; D015331:Cohort Studies; D004838:Epiphyses / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D018570:Risk Assessment; D014182:Transplantation, Autologous; D016896:Treatment Outcome