Physeal Sparing ACL Reconstruction in the Prepubescent Patient

Mininder S. Kocher, MD

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

Specifications

• Total Run Time: 29:51 minutes
• Catalog Number: 5095
• VJO Publication Date: March, 2006