title: Mid-term results of transphyseal anterior cruciate ligament reconstruction in children and adolescents.
abstract: BACKGROUND
  Optimal therapy for anterior cruciate ligament (ACL) rupture in the paediatric population still provokes controversy. Although conservative and operative treatments are both applied, operative therapy is slightly favored. Among available surgical techniques are physeal-sparing reconstruction and transphyseal graft fixation. The aim of this study was to present our mid-term results after transphyseal ACL reconstruction.
  
  
  METHODS
  Fifteen young patients (mean age=12.8±2.6, range=6.2-15.8 years, Tanner stage=2-4) with open physis and traumatic anterior cruciate rupture who had undergone transphyseal ACL reconstruction with unilateral quadriceps tendon graft were prospectively analyzed. All children were submitted to radiological evaluation to determine the presence of clearly open growth plates in both the distal femur and proximal tibia. Postoperatively, all patients were treated according to a standardized rehabilitation protocol and evaluated by radiographic analysis and the Lysholm-Gillquist and IKDC 2000 scores. Their health-related quality of life was measured using the SF-12 PCS (physical component summary) and MCS (mental component summary) questionnaires.
  
  
  RESULTS
  Mean postoperative follow-up was 4.1 years. Mean Lysholm-Gillquist score was 94.0. Thirteen of the 15 knees were considered nearly normal on the IKDC 2000 score. The mean SF-12 questionnaire score was 54.0±4.8 for SF-12 PCS and 59.1±3.7 for SF-12 MCS. No reruptures were observed. Radiological analysis detected one knee with valgus deformity. All patients had a normal gait pattern without restrictions.
  
  
  CONCLUSIONS
  Transphyseal reconstruction of the anterior cruciate ligament shows satisfactory mid-term results in the immature patient.
authors: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
authors: Sandro
authors: S
authors: Kohl
authors: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
authors: Chantal
authors: C
authors: Stutz
authors: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
authors: Sebastian
authors: S
authors: Decker
authors: Division of Paediatric Trauma and Orthopaedics, Department of Paediatric Surgery, University Children's Hospital, Bern, Switzerland.
authors: Kai
authors: K
authors: Ziebarth
authors: Division of Paediatric Trauma and Orthopaedics, Department of Paediatric Surgery, University Children's Hospital, Bern, Switzerland.
authors: Theddy
authors: T
authors: Slongo
authors: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
authors: Sufian S
authors: SS
authors: Ahmad
authors: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
authors: Hendrik
authors: H
authors: Kohlhof
authors: Sonnenhof Orthopaedic Clinics, Bern, Switzerland.
authors: Stefan
authors: S
authors: Eggli
authors: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
authors: Matthias
authors: M
authors: Zumstein
authors: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland. Electronic address: ds.evangelopoulos@gmail.com.
authors: Dimitrios S
authors: DS
authors: Evangelopoulos
mesh_terms: D000293:Adolescent; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D002648:Child; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005684:Gait; D006132:Growth Plate / Q000000981:diagnostic imaging*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D011795:Surveys and Questionnaires; D013710:Tendons / Q000637:transplantation*; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D014182:Transplantation, Autologous
keywords: Anterior cruciate ligament; Children; Growth plate; Quadriceps tendon reconstruction; Rupture; Skeletally immature; Transphyseal reconstruction