title: Intraarticular stabilization following anterior cruciate ligament injury in children and adolescents.
abstract: OBJECTIVE
  Significant controversy exists regarding the potential harm to the growth plate following reconstruction of the anterior cruciate ligament in skeletally immature patients. This study was performed to evaluate the results of a transepiphyseal replacement of the anterior cruciate ligament in skeletally immature patients.
  
  
  METHODS
  Ninety-four skeletally immature patients (56 male and 38 female) with median age 13.7 years (range, 11.6-15.9 years) who underwent arthroscopic transphyseal reconstruction of anterior cruciate ligament with four-strand medial hamstring autograft between 1999 and 2006 were reviewed. All patients had been followed up until skeletal maturity was confirmed.
  
  
  RESULTS
  The average follow-up was 38 months (range 24-60 months). Neither leg length discrepancy nor angular deformities were noted on radiological or clinical measurement. Two patients had radiographic evidence of mild arthrosis at final follow-up. New traumatic injuries occurred in 4 patients, in whom surgical revision was performed. Ligament laxity testing with a KT 1000/2000 arthrometer showed no significant difference between the normal and the operated legs. At follow-up, the median Lysholm score was 89 (range 77-100), and the median Tegner activity score was increased from 3 to 6. The International Knee Documentation Committee score was A in 79 patients (84%) and B in 6 patients (6%) and C in 9 patients (9%). Of the 94 patients, 73 (78%) returned to their similar preoperative sport activities and 90% returned to their preoperative level of daily activities.
  
  
  CONCLUSIONS
  ACL reconstruction with medial hamstring autograft via transepiphyseal drilling and grafting yielded satisfactory clinical results with no growth defects in skeletally immature patient. The preliminary results of this series demonstrated that this surgical technique can be performed in prepubescent patients with efficacy and safety.
  
  
  METHODS
  IV.
authors.affiliation: Sports Medicine Department, Medical Centre, Distomou 5-7, Marousi, Athens, Greece. nikp@otenet.gr
authors.forename: Pantelis
authors.initials: P
authors.lastname: Nikolaou
authors.forename: Alkiviadis
authors.initials: A
authors.lastname: Kalliakmanis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Bousgas
authors.forename: Sarantos
authors.initials: S
authors.lastname: Zourntos
mesh_terms: D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D002648:Child; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012086:Reoperation; D014182:Transplantation, Autologous; D016896:Treatment Outcome