Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Apr 12;18(3):249-257.
doi: 10.1177/18632521241244626. eCollection 2024 Jun.

Arthroscopic repair of proximal anterior cruciate ligament tears in children and adolescents: A systematic review

Marco Turati  1   2   3   4 , Filippo Maria Anghilieri  5 , Simone Daniel Gatti  1   2 , Aurelien Courvoisier  3   4 , Luca Rigamonti  6 , Giovanni Zatti  1   2 , Nicolas Nicolaou  7 , Marco Bigoni  2   6
Affiliations
Review

Arthroscopic repair of proximal anterior cruciate ligament tears in children and adolescents: A systematic review

Marco Turati et al. J Child Orthop. .

Abstract

Purpose: Anterior cruciate ligament repair techniques are of growing interest because they allow for minimally invasive surgery that avoids harvesting of the transplant, without risking growth deficiencies in young patients. The aim of this study is to summarize the published evidence about arthroscopic repair of anterior cruciate ligament proximal tears in skeletally immature patients.

Methods: In total, four studies were included and processed for data extraction after screening for eligibility for this systematic review: one retrospective cohort study and three retrospective case series. Altogether, the four studies included in this review included 61 skeletally immature patients with a mean age of 12.1 years diagnosed with proximal anterior cruciate ligament tear who underwent arthroscopic repair with preservation of the native ligament. The mean follow-up period was 2.8 years.

Results: The most relevant and objective outcome that we considered was re-rupture rate. One study reports a cumulative incidence of graft failure in the first 3 years after surgery of 48.8% while the others report a 0%, 0% and 21.5% re-rupture rate. No growth disturbances were reported in the included studies.

Conclusion: Despite growing interest surrounding anterior cruciate ligament repair techniques, the presence of limited quality studies in the literature means repair cannot be strongly supported at present. Some encouraging data regarding the absence of growth disturbance and functional outcomes does exist, but studies with larger samples are required.

Level of evidence: level IV.

Keywords: Anterior cruciate ligament; arthroscopic fixation; open physes; pediatric.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Structured algorithm for study selection.
Figure 2.
Figure 2.
Different techniques for proximal ACL repair in the skeletally immature. Suture anchor repair with bioabsorbable anchor (1), suture anchor repair with all-suture anchor (2), suture repair with a suture tape augmentation (3), and suture repair with suture tape augmentation and double all epiphyseal tunnels (4). F: femur; T: tibia; P: physis.
See this image and copyright information in PMC

References

    1. Shea KG, Grimm NL, Ewing CK, et al.. Youth sports anterior cruciate ligament and knee injury epidemiology: who is getting injured? In what sports? When? Clin Sports Med 2011; 30(4): 691–706. - PubMed
    1. Dodwell ER, Lamont LE, Green DW, et al.. 20 years of pediatric anterior cruciate ligament reconstruction in New York State. Am J Sports Med 2014; 42(3): 675–680. - PubMed
    1. Mall NA, Chalmers PN, Moric M, et al.. Incidence and trends of anterior cruciate ligament reconstruction in the United States. Am J Sports Med 2014; 42(10): 2363–2370. - PubMed
    1. Beck NA, Lawrence JTR, Nordin JD, et al.. ACL tears in school-aged children and adolescents over 20 years. Pediatrics 2017; 139(3): e20161877. - PubMed
    1. Werner BC, Yang S, Looney AM, et al.. Trends in pediatric and adolescent anterior cruciate ligament injury and reconstruction. J Pediatr Orthop 2016; 36(5): 447–452. - PubMed