title: Functional outcome after transphyseal anterior cruciate ligament reconstruction in young patients with open growth plates.
abstract: BACKGROUND
  This study evaluates sports ability, rotational laxity and potential growth changes in children after transphyseal ACL reconstruction with metaphyseal fixation technique, considering physis biology by placing drill holes vertically in the femoral anatomic origin in order to reduce volumetric injury to the physis.
  
  
  METHODS
  In this retrospective trial of 42 patients data were collected. Thirty-seven were reviewed measuring rotational laxity and anteroposterior tibial translation using the Laxitester (ORTEMA Sport Protection, Markgroeningen, Germany) and the KT1000. Clinical examination was evaluated with the IKDC 2000 knee examination form. Leg axis was determined with digital photography and leg length was assessed clinically. Sports ability was assessed with questionnaires including subjective IKDC, Tegner Activity Scale, Activity Rating Scale and a questionnaire on sports and level of sports.
  
  
  RESULTS
  Mean follow-up was 24.9months. Mean age at surgery was 13.2years in boys and 13.1years in girls. IKDC 2000 grading was A or B in 28 patients and C in nine patients. Significant increased anterior tibial translation was observed in neutral position and in external tibia rotation. No growth abnormalities were seen. Fifty-seven percent of the patients were able to participate in competitive sports at follow-up.
  
  
  CONCLUSIONS
  Transphyseal ACL reconstruction with metaphyseal fixation in children with open growth plates can be done with low risk of growth changes. Return to competitive sports is possible although low rotational laxity still exists.
  
  
  METHODS
  IV.
authors.affiliation: Abteilung für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany. Electronic address: christian.holwein@lrz.tum.de.
authors.forename: C
authors.initials: C
authors.lastname: Holwein
authors.affiliation: Abteilung für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany; OrthoPlus München, Alte Börse Lenbachplatz 2a, 80333 München, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Hinterwimmer
authors.affiliation: Universitätsklinikum Freiburg, Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Forschungslabor Hugstetter Straße 55, 79106 Freiburg, Germany.
authors.forename: H O
authors.initials: HO
authors.lastname: Mayr
authors.affiliation: Department Psychologie, Medical School Hamburg, Kaiserkai 1, 20457 Hamburg, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Lämmle
authors.affiliation: Abteilung für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany; OrthoPlus München, Alte Börse Lenbachplatz 2a, 80333 München, Germany.
authors.forename: P U
authors.initials: PU
authors.lastname: Brucker
authors.affiliation: OCM Klinik, Orthopädische Chirurgie München, Steiner Str. 6, 81369 München, Germany.
authors.forename: E O
authors.initials: EO
authors.lastname: Münch
authors.affiliation: Abteilung für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: A B
authors.initials: AB
authors.lastname: Imhoff
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction; D002648:Child; D005260:Female; D006132:Growth Plate; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D000068958:Return to Sport; D016896:Treatment Outcome
keywords: ACL; Children; Return to sport; Rotational laxity; Transphyseal