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ACL Reconstruction By Graft Link All-Inside Technique In Skeletal Immature Patients.

ACL Reconstruction By Graft Link All-Inside Technique In Skeletal Immature Patients.

Horacio F. Rivarola-Etcheto, MD, ARGENTINA Cristian Collazo Blanchod, MD, ARGENTINA Marcos Meninato, MD, ARGENTINA Facundo Cosini, MD, ARGENTINA Juan Martín Carraro, MD, ARGENTINA Carlos Mendoza Puello, MD, ARGENTINA

Hospital Austral, Pilar, Buenos Aires, ARGENTINA

2021 Congress   ePoster Presentation     Not yet rated


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Summary: Surgical outcomes depend on the ability of the graft to reproduce the ACL restriction action and restore normal knee kinematics without damaging other structures that may compromise medium or long-term results.

Anterior cruciate ligament (ACL) injuries are an increasingly recognized problem in the juvenile population. Unfortunately, outcomes with conservative treatment are extremely poor. Adult reconstruction techniques are inappropriate to treat skeletally immature patients due to the risk of physeal complications, including limb-length discrepancy and angular deformities. “Physeal-sparing” reconstruction techniques exist, but their ability to restore knee stability is not well understood. We describe a combined epiphyseal ACL reconstruction for use in skeletally immature patients. This is an all-inside technique with the femoral tunnel drilled retrograde and the tibial tunnel drilled retrograde; both tunnels are entirely within the epiphysis. Fixation of the hamstring autograft is achieved with soft-tissue buttons on both femur and tibia. We present case examples of 2 patients who underwent all-inside, all-epiphyseal reconstruction and our postoperative rehabilitation protocol.
Key words: ACL reconstruction, adolescents, pediatric, all-inside, graft link, open physis.