2017 ISAKOS Biennial Congress ePoster #1806

 

Arthroscopic Physeal Sparing Posterior Cruciate Ligament Reconstruction in a Skeletally Immature Patient: A Systematic Review and Novel Surgical Technique

Moin Khan, MD, MSc, FRCSC, Hamilton, ON CANADA
Tyrrell Burrus, MD, Ann Arbor, MI UNITED STATES
Edward M. Wojtys, MD, Ann Arbor, MI UNITED STATES
Asheesh Bedi, MD, Ann Arbor, MI UNITED STATES

University of Michigan, Ann Arbor, Michigan , UNITED STATES

FDA Status Cleared

Summary

Surgical techniques to avoid the physis in PCL reconstruction in paediatric patients allow for return to previous level of sports participation without instability

Abstract

Introduction

Injuries to the posterior cruciate ligament (PCL) in skeletally immature patients are uncommon. We present a case of an intrasubstance PCL tear and our technique of physeal sparing reconstruction along with a systematic review of the topic to provide a comprehensive summary of the current literature.

Methods

We searched MEDLINE, EMBASE, PubMED, CENTRAL databases for all articles related to physeal sparing PCL reconstruction. We performed duplicate screening of studies and data extraction regarding patient demographics, clinical and imaging findings and surgical techniques.

Results

Three case reports were identified of physeal sparing PCL reconstruction in skeletally immature individuals. All patients failed conservative treatment consisting of physiotherapy and functional bracing and required physeal sparing reconstruction. Two cases were done arthroscopically and one reported an open approach. All patients reported stable knees and returned to preoperative level of athletic participation.

Conclusion

Surgical techniques to avoid the physis allow for return to previous level of sports participation without instability. We present a novel surgical technique of physeal sparing PCL reconstruction with improvements over those currently described in the literature.