2015 ISAKOS Biennial Congress ePoster #1384

The Reconstruction of ACL in Adolescents with Trans-Tibial Trans-Epiphyseal Technique: Retrospective Study of 71 Patients

Alessandro Quaglia, MD, Milan ITALY
Corrado Bait, MD, Milan ITALY
Antonio Orgiani, MD, Rozzano (Mi) ITALY
Emanuele Prospero, MD, Milan ITALY
Luca Pulici, MD, PT, BSc, Rho, MI ITALY
Piero Volpi, MD, Rozzano (Mi) ITALY

Humanitas, Rozzano, Italy, ITALY

FDA Status Not Applicable

Summary: The trans-tibial trans-epiphyseal technique of ACL reconstruction, according to the results obtained, seems to be a valid alternative in the hands of the orthopaedic surgeon offering an excellent safety profile and at the same time very good clinical results

Rate:

Abstract:

Background

In the last years, traumatic ligament injuries of the knee, in particular injuries of the anterior cruciate ligament (ACL) in adolescents have increased significantly. The main theoretical risk in ACL reconstruction (ACLR) in a young and skeletally immature patient is the potential iatrogenic damage to the growth plates. Several techniques were proposed, in the last years, to reduce this kind of risk.

Purpose

The aim of the study was to evaluate, in a group of adolescents, the onset of varus-valgus deviations in the sagittal plane aftere trans-tibial trans-epiphyseal technique of ACL reconstruction with a follow-up of at least two years.
Study design:Case Series (Level IV)

Methods

71 patients aged 12 – 15 years old have undergone ACL surgical reconstruction with STG using arthroscopy. All patients were evaluated clinically with the visual analog scale (VAS), the Lysholm score and the Tegner activity score at the time of surgery. All patients were revaluated after a follow up period of at least two years (T1) using the visual analog scale (VAS), the Lysholm score, the Tegner activity score and X-ray in order to compare the operated limb with the healthy control limb.

Results

We have observed only 3 patients with valgus difference exceeding 2° in the knee axis, between the operated limb and the healthy control limb (4.23%: 95% CI 0.88% - 11.86%). The average difference was < 1 degree (0.3°, 95% CI 0.04 – 0.55).

Conclusion

The trans-tibial trans-epiphyseal technique of ACL reconstruction, according to the results obtained, seems to be a valid alternative in the hands of the orthopaedic surgeon offering an excellent safety profile and at the same time very good clinical results.
Key Terms: Knee; ACL reconstruction; adolescent; outcome, trans-tibial technique, trans-epiphyseal