Physeal-Sparing Anterior Cruciate Ligament Reconstruction with Iliotibial Band
Division of Sports Medicine, Department of Orthopaedic Surgery, Children's Hospital Boston, Boston, MA 02115, USA.Clinics in sports medicine (Impact Factor: 1.22). 10/2011; 30(4):767-77. DOI: 10.1016/j.csm.2011.07.005
Treatment of anterior cruciate ligament (ACL) injuries in skeletally immature athletes is controversial. Whereas operative treatment places risk to the physis, nonoperative management may lead to functional instability. By performing physeal-sparing intraarticular and extraarticular iliotibial band reconstruction of the ACL, the risk of physeal injury is reduced and stability of the knee is restored. This article reviews the indications for iliotibial band reconstruction of the ACL in the skeletally immature athlete, surgical technique, pitfalls, and results of treatment.
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ABSTRACT: Unlabelled: The management of the skeletally immature athlete sustaining injury to the anterior cruciate ligament and other knee structures provides multiple challenges for both the treating clinicians and parents of the injured child. The diagnostic process and subsequent decision making present additional complexities because of the developmental anatomy and the potential for disturbance of normal growth patterns by some surgical interventions. In the following case report, the course to appropriate management of a young athlete is detailed, including the contributions of imaging results. The reconstructive options available to orthopedic surgeons and the patient's post-operative progression are also briefly discussed. Rehabilitation practitioners require an understanding of the unique issues present when providing care for pediatric and adolescent athletes with knee injuries in order to assist in optimal decision making in the phases during which they are involved. Level of evidence: 5 (Single Case Report).12/2012; 7(6):678-90.
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