0
Case Reports   |    
Growth Stimulation Following an All-Epiphyseal Anterior Cruciate Ligament Reconstruction in a ChildA Case Report
Senthil T. Nathan, MD1; Marios G. Lykissas, MD, PhD1; Eric J. Wall, MD1
1 Division of Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2017, Cincinnati, OH 45229-3039. E-mail address for E.J. Wall: eric.wall@cchmc.org
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Investigation performed at the Division of Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Feb 13;3(1):e14 1-6. doi: 10.2106/JBJS.CC.L.00179
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

Over the past decade, there has been a substantial increase in the number of reported intrasubstance tears of the anterior cruciate ligament (ACL) in children younger than twelve years of age or in prepubescent children1-6. Multiple studies have emphasized the need for early ACL reconstruction in skeletally immature patients to prevent the development of meniscal tears and early knee arthrosis7-10. The native ACL in children always courses from the distal femoral epiphysis to the proximal tibial epiphysis. If the usual ACL reconstruction used in adults is performed on a child or adolescent, this anatomy becomes problematic because tunnels are drilled through the growth plates into the distal part of the femur and the proximal tibial metaphyses. In children with wide-open growth plates, a solidly fixed and tensioned graft, placed as in adults, may potentially cause a “tether effect” that can retard growth at these growth plates11,12. In order to avoid tether or bone-bar formation, multiple partial or complete physeal-sparing techniques to reconstruct the ACL in this age group have been proposed1,6,13-16.
Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS Case Connector?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    Results
    Provided by:
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    12/04/2013
    New York - Icahn School of Medicine at Mount Sinai
    04/02/2014
    W. Virginia - Charleston Area Medical Center
    12/31/2013
    S. Carolina - Department of Orthopaedic Surgery Medical Univerity of South Carlonina
    02/28/2014
    District of Columbia (DC) - Children's National Medical Center