ACL-LET Didactic Presentations - AOSSM/POSNA Pediatric Surgical Skills Course-ACL-LET: 6. Transphyseal ACL Reconstruction - What I do Different for an ACL Reconstruction in Skeletally Immature Patients

ACL-LET: 6. Transphyseal ACL Reconstruction - What I do Different for an ACL Reconstruction in Skeletally Immature Patients

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Video Transcription

Video Summary

In the video, J.R. Cruz discusses transficial ACL reconstruction in skeletally immature patients. He highlights the importance of assessing skeletal maturity and the risk of growth disturbance after ACL reconstruction. Different methods of assessing skeletal maturity are mentioned, including the Groyleg and Pyle Atlas and the HSS shorthand method. The use of knee MRI to assess bone age is also discussed. It is emphasized that obtaining a full-length standing alignment film preoperatively is crucial. Transficial ACL reconstruction is described as a suitable procedure for older adolescents with less than two years of growth remaining. The use of soft tissue grafts and the avoidance of fixation across the physis are emphasized. The hybrid ACL reconstruction, which combines epiphyseal femoral tunnel with a vertical tibial tunnel, is mentioned as an option for younger patients. Several case series are cited to support the efficacy of these techniques. Overall, it is important to accurately assess bone age and consider the risks and benefits of different ACL reconstruction methods in skeletally immature patients. (Words: 199)

Keywords

transficial ACL reconstruction

skeletally immature patients

assessing skeletal maturity

growth disturbance

bone age assessment