Anterior cruciate ligament injuries in the young athlete with open physes

Abstract

From 1980 to 1985, 40 patients under the age of 14 with open physes were treated for midsubstance tears of the ACL at the Methodist Sports Medicine Center. In this series, 16 were treated conservatively with re habilitation, bracing, and counseling on activity modifi cation. The remaining 24 patients underwent arthros copic examination and either an extraarticular or intra articular reconstruction based on growth potential. The average followup was 27 months for the con servative group and 26 months for the surgical group. In the conservative group, six patients underwent ar throscopy for meniscal tears, four medial and two lat eral. Only seven patients returned to sports, all experi encing recurrent episodes of giving way, effusions, and pain. In the surgical group, 12 medial and 6 lateral meniscal tears were found at arthroscopy. There were 10 ex traarticular reconstructions and 14 intraarticular recon structions. All 24 returned to sports activity, and 22 of the 24 are still competing. The two remaining patients both suffered reinjury 3 years after their surgery. We recommend arthroscopy and examination under anesthesia for the young patient with ACL tears. Based on the amount of instability, presence or absence of meniscal tears, and athletic desires of the patient and his or her family, a treatment plan can be undertaken.