Paediatric proximal ACL tears managed with direct ACL repair is safe, effective and has excellent short-term outcomes
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Paediatric proximal ACL tears managed with direct ACL repair is safe, effective and has excellent short‑term outcomes J. Dabis1 · S. K. Yasen1 · A. J. Foster1 · J. Lee Pace2,3 · A. J. Wilson4,5 Received: 28 April 2019 / Accepted: 21 January 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose Anterior cruciate ligament (ACL) surgery in the paediatric population has long been a challenge. Non-operative treatment will result in persistent instability which can lead to chondral and meniscal injuries. The results of primary open ACL repair are poor. Concerns of growth plate disturbance with transphyseal techniques and issues with relatively smalldiameter grafts in Tanner 1 and 2 patients, which are inadequate, have contributed to these challenges. With advancing instrumentation, there is renewed interest in ACL repair. The minimally invasive approach of arthroscopic primary ACL repair retains the native ligament. The objective and subjective outcomes at 2 years are presented. Methods Paediatric patients, less than 16 years of age, presenting acutely with complete proximal ACL ruptures underwent direct arthroscopic ACL repair, reinforced by a temporary internal brace, which was subsequently removed after 3 months. Patient-reported outcome measures including the Lysholm, Tegner and KOOS scores were collected at 6 months, 1 year and 2 years post-operatively. Results Twenty patients (age 6–16) completed data at 2 years post-operatively. There were no failures, no complications and no growth disturbance out to 2 years. The 2-year postoperative outcomes; Lysholm 95 (90–100), Tegner 7 (6–10), KOOS-Child 96.5 (88.9–100) demonstrated statistically significant improvements following surgery (p
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