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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2016

01-06-2016 | Knee

Paediatric ACL repair reinforced with temporary internal bracing

Authors: James O. Smith, Sam K. Yasen, Harry C. Palmer, Breck R. Lord, Edward M. Britton, Adrian J. Wilson

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2016

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Abstract

Purpose

Instability following non-operative treatment of anterior cruciate ligament (ACL) rupture in young children frequently results in secondary chondral and/or meniscal injuries. Therefore, many contemporary surgeons advocate ACL reconstruction in these patients, despite the challenges posed by peri-articular physes and the high early failure rate. We report a novel management approach, comprising direct ACL repair reinforced by a temporary internal brace in three children.

Methods

Two patients (aged 5 and 6 years) with complete proximal ACL ruptures and a third (aged seven) with an associated tibial spine avulsion underwent direct surgical repair, supplemented with an internal brace that was removed after 3 months.

Results

Second-look arthroscopy, examination and imaging at 3 months confirmed knee stability and complete ACL healing in all cases. Normal activities were resumed at 4 months, and excellent objective measures of function, without limb growth disturbance, were noted beyond 2 years.

Conclusion

ACL repair in young children using this technique negates the requirement and potential morbidity of graft harvest and demonstrates the potential for excellent outcome as an attractive alternative to ACL reconstruction, where an adequate ACL remnant permits direct repair.

Level of evidence

IV.
Appendix
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Metadata
Title
Paediatric ACL repair reinforced with temporary internal bracing
Authors
James O. Smith
Sam K. Yasen
Harry C. Palmer
Breck R. Lord
Edward M. Britton
Adrian J. Wilson
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4150-x

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