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Am J Sports Med. 2002 Sep-Oct;30(5):697-703.

Partial tears of the anterior cruciate ligament in children and adolescents.

Author information

  • 1Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

Abstract

BACKGROUND:

The functional outcome after partial anterior cruciate ligament tears in children and adolescents treated without reconstruction has not been established.

HYPOTHESIS:

Nonreconstructive management of partial anterior cruciate ligament tears can be effective in certain pediatric patients.

STUDY DESIGN:

Prospective cohort study.

METHODS:

We studied 45 skeletally mature and immature patients 17 years of age or less who had an acute hemarthrosis, magnetic resonance imaging signal changes, grade A or B Lachman and pivot shift result, and an arthroscopically documented partial anterior cruciate ligament tears. All patients were treated without reconstruction, underwent a structured rehabilitation program, and were followed up for a minimum of 2 years.

RESULTS:

Fourteen patients (31%) underwent subsequent reconstruction. Significant associations with subsequent reconstruction included tears that were greater than 50%, predominantly posterolateral tears, a grade B pivot shift test result, and older chronologic and skeletal age. Among patients who did not require reconstruction, those with tears that were greater than 50% or predominantly posterolateral had significantly lower Lysholm, satisfaction, and Cincinnati Knee Scale scores.

CONCLUSIONS:

Nonreconstructive management is recommended for partial anterior cruciate ligament tears in children and adolescents 14 years of skeletal age or younger with normal or near-normal Lachman and pivot shift results. Reconstruction is recommended in older athletes or in those with greater than 50% or predominantly posterolateral tears.

Copyright 2002 American Orthopaedic Society for Sports Medicine

PMID:
12239005
[PubMed - indexed for MEDLINE]
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