Developmental changes in ACLs and semitendinosus tendons dimensions according to age in children
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(2020) 15:363
RESEARCH ARTICLE
Open Access
Developmental changes in ACLs and semitendinosus tendons dimensions according to age in children Ryszard Tomaszewski1,2,3* , Dominika Smyczek4, Izabela Woś-Cieśla5, Ewa Kluczewska5, Tomasz Koszutski4 and Łukasz Wiktor3 Abstract Purpose: Managing anterior cruciate ligament (ACL) injuries in skeletally immature patients remains difficult. The main aim of this study was to retrospectively compile normative data on the cross-sectional area (CSA) of the semitendinosus tendon (ST) and the diameter of the ACL in children and young adults. Methods: Knee magnetic resonance imaging (MRI) examinations were performed for a 2-year period in 132 patients (83 female and 49 male patients). The mean age was 14.9 years (8–18 years). Measurements of the ST CSA were performed on axial views in greyscale by two independent researchers. The ACL diameter was measured as well. Results: The results show the CSA of the ST was related to age, and its growth was not linear. The highest growth rate of the CSA of the ST occurred at age 12–13 at the level of the femoral growth plate and at the level of the tibial plateau. The growth of the ACL diameter was linear until 18 years of age. Conclusions: ST growth (measured in CSA increments) is almost complete at the age of 13, even though the growth is not linear. ACL growth measured in diameter increments proceeds linearly from 8 to 18 years of age. MRI is a clinically useful tool for assessing hamstring tendon grafts preoperatively. Level of evidence: Level III, diagnostic studies Keywords: ACL reconstruction, Hamstring tendons, Autograft, Children
Introduction The annual incidence of anterior cruciate ligament (ACL) injury in children and adolescents is rising steadily, and it accounts for 0.5–3% of all ACL injuries [1]. Many minors could be affected by this injury, but the available epidemiological information on ACL tears in skeletally immature patients is limited [2–5]. There are * Correspondence: [email protected] 1 Department of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre, ul. Medykow 16, 40-752 Katowice, Poland 2 Faculty of Science and Technology, Institute of Biomedical Engineering, University of Silesia in Katowice, Katowice, Poland Full list of author information is available at the end of the article
two treatment options for paediatric patients with an ACL injury, including rehabilitation only or ACL reconstruction followed by high-quality rehabilitation. This approach allows restored stability of the knee, reduced meniscal and chondral pathologies and minimized risks for femoral or tibial growth arrest in children with an ACL injury. Clinical examination, classic radiographs and magnetic resonance imaging (MRI) are the basis for diagnosing patients and determining whether they qualify for surgical treatment [2, 6–8]. A variety of reconstructive techniques have been described, including transphyseal, physeal-sparing and partial transphyseal ACL
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