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HomeIntroductionTreatment and managementConsiderations in treating childrenAuthor's preferred surgical techniqueConclusion

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Home « Clinical Services « Children's Orthopaedics

Technical Information about ACL Injuries in Children.

Last updated Thursday, January 13, 2005

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Author's preferred surgical technique

The goal of ACL reconstruction in the skeletally immature patient is to restore normal anterior laxity of the knee joint with the least amount of risk to subsequent growth. The preferred technique is the use of both tibial and femoral centrally placed drill holes, hamstring tendon autografts, fixation distant from the physis, and avoidance of dissection near the physis. The use of small centrally placed tunnels and soft tissue grafts minimizes the risk of physeal closure. Should closure occur the centrally placed tunnels would not likely result in an angular deformity. By not dissecting near either the tibial or femoral physis, interruption of blood supply is minimized. Keeping fixation devices distant from the physis avoids the chance of inadvertent influence. The use of an EndoButton CL (Acufex, Smith & Nephew; Mansfield, MA) avoids fixation devices such as interference fit screws that may traverse the physis.

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