The Effect of Placing a Tensioned Graft Across Open Growth Plates

Edwards, T. Bradley; Greene, Craig C.; Baratta, R.; Zieske, Arthur W.; Willis, R. Baxter

doi:10.2106/00004623-200105000-00012

Cited by 165 publications

(78 citation statements)

References 22 publications

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“…Their conclusion was that the graft prevents bone formation across the physis. Edwards et al (2001) [9] were using a canine model as well. Their main alteration was a tensioned graft across the epiphyseal plates of 12 dogs.…”

Section: Discussionmentioning

confidence: 99%

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Multicenter-study of operative treatment of intraligamentous tears of the anterior cruciate ligament in children and adolescents

Gebhard

Ellermann

Hoffmann

et al. 2006

Knee Surg Sports Traumatol Arthr

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Tears of the anterior cruciate ligament in skeletally immature patients were operated with four different methods and their outcome compared to each other. Sixty-eight patients (33 males, 35 females), mean 12.5 years, were treated in four different centers from 1984 to 2001. Twenty-eight patients underwent the ACL-reconstruction with hamstring grafts, 16 patients with bone-patella-bone autografts, 12 patients with quadriceps grafts and 12 patients with facia lata. The mean follow-up was 32 months. Postoperative evaluation included radiographs, KT-1000/2000 stability measurements, Lysholm score, The Tegner activity scale and IKDC score. Neither leg length discrepancy nor angular deformities were noted. Mean KT-1000 difference was 2.1 mm, mean postoperative Lysholm knee score 93.3, IKDC 87% normal or nearly normal. The Tegner index decreased from 6.6 to 5.7. In total, six patients developed instability due to an adequate trauma 1 year after the index operation. Two patients showed mild arthrotic changes. All but two patients were able to return to the same level of preoperative sports participation. None of the four methods studied showed major differences in outcome compared to the other. No growth disturbance could be noted.

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Section: Discussionmentioning

confidence: 99%

“…Animal studies [9,17,33] are essential steps in understanding the growing skeleton but should not be overinterpreted.…”

Section: Discussionmentioning

confidence: 99%

Multicenter-study of operative treatment of intraligamentous tears of the anterior cruciate ligament in children and adolescents

Gebhard

Ellermann

Hoffmann

et al. 2006

Knee Surg Sports Traumatol Arthr

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“…fixation or bony graft material across the physis or involve damage to the perichondral ring [24][25][26]. Based on animal models [12,36,39] and these clinical examples, the following general principles now are accepted [23,24]: fixation should not cross the physis, drill holes across the physis should be centrally located and as small as possible, and tensioning a soft tissue graft across a physis should be avoided if a large amount of growth remains.…”

Section: Introductionmentioning

confidence: 99%

All-epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients

Lawrence

Bowers

Belding

et al. 2010

Clinical Orthopaedics &Amp; Related Research

149

139

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“…It has been shown in animal models that: 1) ACL tunnels filled with soft tissue grafts are less likely to form physeal bars and cause shortening or angular deformity compared with empty tunnels [34,35], irrespective of the tunnel size [35]; 2) overtensioning of transphyseal grafts in skeletally immature individuals may predispose to growth disturbance [36]; 3) the amount of physeal damage and the presence of bioabsorbable devices at the level of the physis affect the chance of growth arrest [37][38][39]. Animal studies suggest that damage to less than 5% of the physis is unlikely to affect growth but that injury to 7-9% of the physis may cause a growth arrest [37][38][39].…”

Section: Growth Effects Of Physeal Damagementioning

confidence: 99%

Pediatric anterior cruciate ligament reconstruction

McConkey

Bonasia

Amendola³

2011

Curr Rev Musculoskelet Med

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An increasing number of anterior cruciate ligament (ACL) injuries are seen in children now than in the past due to increased sports participation. The natural history of ACL deficient knees in active individuals, particularly in children is poor. Surgical management of ACL deficiency in children is complex due to the potential risk of injury to the physis and growth disturbance. Delaying ACL reconstruction until maturity is possible but risks instability episodes and intra-articular damage. Surgical options include physeal-sparing, partial transphyseal and complete transphyseal procedures. This article reviews the management of ACL injured skeletally immature patients including the functional outcome and complications of contemporary surgical techniques.

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The Effect of Placing a Tensioned Graft Across Open Growth Plates

Cited by 165 publications

References 22 publications

Multicenter-study of operative treatment of intraligamentous tears of the anterior cruciate ligament in children and adolescents

Multicenter-study of operative treatment of intraligamentous tears of the anterior cruciate ligament in children and adolescents

All-epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients

Pediatric anterior cruciate ligament reconstruction

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