Surgical ACL reconstruction has excellent results in the adolescent patient

Ten-year data indicate that 93% of young patients had good to excellent results with the surgery.

Issue: Issue 5 2009

VIENNA — A 10-year study has found surgical repair to be a safe and effective treatment of ACL lesions in adolescent patients.

“We have learned that the conservative treatment for ACL lesions in adolescents is not good,” Gian Luigi Canata, MD, of Italy, said here at the 10th EFORT Congress. “But there are no level I or II studies that have addressed operative techniques or the timing of the reconstruction.”

To address this, Canata and colleagues undertook a retrospective evaluation of case reports of adolescents who were surgically treated for ACL reconstruction using reconstruction with patellar tendon or arthroscopic reinsertion of the ligament.

Two groups

Data included 75 cases of surgical treatment of instability in pediatric patients who received treatment between 1990 and 2006. One group of 59 cases was treated with patellar tendon, and a second group of 16 cases with proximal lesions and good ligament quality received arthroscopic repair of the ACL.

Mean follow-up for both groups was 120 months, and clinical evaluations were performed using the IKDC (International Knee Documentation Committee) 2000 scores. Radiographic and MRI evaluations were also performed.

Canata said his indications for performing the procedures in these patients are radiographic or MRI evidence of the lesion and demonstrated laxity.

No functional compromise

“We found that there was no differences between the two groups in terms of the assessing the ACL with the IKDC or the radiographic assessments, and we did not observe any length difference or imbalance with any of the patients,” he said. Overall, 93% of cases had good results with the surgical treatments.

“The use of the patellar tendon for the repair does not result in having compromised the functionality of the extensor apparatus,” he said.

An attendee of the session commented that he has concerns about mobility in his adolescent patients following these procedures. Canata responded that he has seen no rigidity following the ACL reconstructions.

“It is incredible how happy these patients are,” he said. “Also, there is a high rate of return to sport activity.”

For more information:

Gian Luigi Canata, MD, can be reached at Instituto di Medicina dello Sport di Torino, Corso Duca degli Abruzzi 30, 10129 Torino, Italy; +39-11-5817566; fax: +39-11-5805014; e-mail: canata@ortosport.it.

Reference:

Canata GL. ACL reconstruction of insertion in the adolescent: A 10-year follow-up. Paper #F39. Presented at the 10th EFORT Congress. June 3-6, 2009. Vienna.