All Epiphyseal ACL Reconstruction Improves Knee Kinematics

INTRODUCTION Treatment of ACL injuries in skeletally immature patients is complicated by the fact that adult reconstruction techniques violate the growth plate, potentially leading to leg length discrepancies and angular deformities in skeletally immature patients. ACL injuries are commonly treated conservatively until growth plate closure; however, cartilage damage, meniscal injuries, and early osteoarthritis are common. The Anderson technique for pediatric ACL reconstruction utilizes all epiphyseal tunnels adjacent to the growth plate [1]. ACL injury leads to increased anterior translation, internal rotation, medial shift and valgus orientation of the tibia, with the largest changes occurring with the knee near full extension [2, 3]. The current study was performed to determine if all-epiphyseal reconstruction can reverse the kinematic changes caused by ACL injury.