title: Arthroscopic transphyseal anterior cruciate ligament reconstruction in adolescent athletes.
abstract: To evaluate the 5-year outcome of arthroscopic transphyseal anterior cruciate ligament (ACL) reconstruction in 19 adolescent athletes.
  
  
  
  14 male and 5 female adolescent athletes aged 12 to 16 (mean, 13.9) years with Tanner stage 2 or 3 open physes underwent arthroscopic transphyseal ACL reconstruction by a single surgeon and were followed up for 5 years. Patients were evaluated using the numerical rating score (NRS) for pain, knee osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, and Lysholm Score, as well as the leg length discrepancy, femorotibial alignment, varus or valgus deformities, active and passive knee range of motion.
  
  
  
  At 5-year follow-up, physes were closed in all patients. The mean NRS for pain improved from 7.2 to 1.6; the KOOS improved from 55.3 to 88; the mean IKDC score improved from 34.5 to 84; the mean Tegner Activity Scale improved from 2.7 to 8.2 and was comparable with that before injury (8.4); and the mean Lysholm score improved from 36.3 to 84.6. All except 2 patients returned to their pre-injury level of sports activity after a mean of 25 weeks. The 2 exceptions had a 2+ Jerk test and a 3+ Lachman test; one of them also had positive signs for a lateral meniscal lesion. Both had sustained a second trauma not long before the 5-year follow-up. Two patients had reduced sensitivity in the anteromedial aspect of the proximal third of the tibia. One patient had leg length discrepancy of +1.5 cm owing to overgrowth response of the physis.
  
  
  
  Transphyseal ACL reconstruction is a viable option for skeletally immature patients, with high reproducibility, a high rate of return to sport, and a low incidence of growth disturbance. Early surgery can prevent the onset of meniscal lesions and early osteoarthritis.
authors.affiliation: Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, School of Medicine, Università Politecnica delle Marche, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Dei Giudici
authors.affiliation: Department of Orthopaedics, Istituto Chirurgico Ortopedico Traumatologico ICOT, Latina, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Fabbrini
authors.affiliation: Department of Orthopaedics, Istituto Chirurgico Ortopedico Traumatologico ICOT, Latina, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Garro
authors.affiliation: Department of Methods and Models for Economy, Territory and Finance, Sapienza Università di Roma, Roma, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Arima
authors.affiliation: Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, School of Medicine, Università Politecnica delle Marche, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gigante
authors.affiliation: Department of Orthopaedics, Istituto Chirurgico Ortopedico Traumatologico ICOT, Latina, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Tucciarone
mesh_terms: D000293:Adolescent; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery*; D005260:Female; D006132:Growth Plate / Q000601:surgery*; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery
keywords: adolescent; anterior cruciate ligament reconstruction