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Growth disturbances without growth arrest after ACL reconstruction in children

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Growth arrest is a major concern after ACL reconstruction in children. It usually occurs in patients near to closure of the growth plates. Growth disturbances without growth arrest are also possible and more vicious; the authors analyse the mechanism of two patients with growth disturbance due to overgrowth following ACL reconstruction. One was a symmetrical overgrowth process with 15 mm limb length discrepancy treated with percutaneous epiphysiodesis. Full correction at the time of skeletal maturity was achieved. The second patient developed an asymmetrical overgrowth with progressive tibial valgus deformity. This mechanism was similar to a posttraumatic tibial valgus deformity. After nonoperative treatment, a spontaneous correction of the deformity was noticed. Both children were young (7 and 10 years old) at the time of ACL reconstruction with an autologous iliotibial band graft. The clinical relevance of overgrowth disturbance is usually limited when compared to growth arrest but could require a second surgical procedure as reported in this study. Parents must be informed that even in experienced hands, and despite the use of a physeal sparing technique, this specific risk of growth disturbance is still present.

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Authors and Affiliations

  1. Service de Chirurgie Orthopédique Pédiatrique, Hôpital Universitaire Femme Mère Enfant de Lyon, Université Claude Bernard Lyon I, 59 Boulevard Pinel, 69677, Bron, France

    Franck Chotel & Jérôme Bérard

  2. Service de chirurgie orthopédique, de traumatologie et de médecine du sport, Centre Hospitalier Lyon-Sud, chemin du Grand Revoyer, 69495, Pierre Bénite, Cedex, France

    Julien Henry, Julien Chouteau & Bernard Moyen

  3. Service de Chirurgie Orthopédique, Centre de l’Appareil Locomoteur de Médecine du Sport et de Prévention, Centre Hospitalier de Luxembourg-Clinique d’Eich, 78, rue d’Eich, 1460, Luxembourg, Luxembourg

    Romain Seil

Authors
  1. Franck Chotel
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  2. Julien Henry
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  3. Romain Seil
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  4. Julien Chouteau
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  5. Bernard Moyen
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  6. Jérôme Bérard
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Correspondence to Franck Chotel.

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Chotel, F., Henry, J., Seil, R. et al. Growth disturbances without growth arrest after ACL reconstruction in children. Knee Surg Sports Traumatol Arthrosc 18, 1496–1500 (2010). https://doi.org/10.1007/s00167-010-1069-5

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  • DOI: https://doi.org/10.1007/s00167-010-1069-5

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