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Physeal Sparing ACL Reconstruction in the Prepubescent Patient

Mininder S. Kocher, M.D.

 

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Fear of iatrogenic growth disturbance has prevented the routine use, in children, of anatomic methods of anterior cruciate ligament replacement that have proven successful in adults. To minimize the risk of growth disturbance, extra-articular or modified physeal sparing procedures have been performed to stabilize the knee, but these procedures do not provide isometry. Dr. Min Kocher of Boston Children's Hospital conducted a study to evaluate the results of a transepiphyseal replacement of the anterior cruciate ligament in skeletally immature athletes. He concludes "transepiphyseal replacement of the anterior cruciate ligament, a technically demanding procedure with a small margin of error, should be attempted only by accomplished knee surgeons. The preliminary results in this small series, however, demonstrate that this surgical technique can be performed in prepubescent patients with efficacy and relative safety." In this JBJS/VJO video supplement to his article, the viewer is provided with an in-depth presentation of Dr. Kocher's surgical technique, including pearls on indications, contraindications, avoiding complications and postoperative protocol.

Material Covered

  • Preoperative Planning
  • Patient/Family Consultation
  • Indications/Contraindications
  • Avoiding Complications

See the Corresponding JBJS Article:

Mininder S. Kocher, Sumeet Garg, and Lyle J. Micheli
Physeal Sparing Reconstruction of the Anterior Cruciate Ligament in Skeletally Immature Prepubescent Children and Adolescents
J. Bone Joint Surg. Am., Nov 2005; 87: 2371 - 2379. [Abstract] [Full Text]

Mininder S. Kocher, Sumeet Garg, and Lyle J. Micheli
Physeal Sparing Reconstruction of the Anterior Cruciate Ligament in Skeletally Immature Prepubescent Children and Adolescents. Surgical Technique
J Bone Joint Surg Am. 2006;88(Supp 1):283-293. [Abstract] [Full Text]
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 Kocher MS
Specifications
  • Catalog Number: 5095
  • VJO Publication Date: March 2006
  • Total Run Time: 29:51
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Copyright © 2006 by the Video Journal of Orthopaedics.