Partial tears of the anterior cruciate ligament in children and adolescents.
简介
BACKGROUND: The functional outcome after partial anterior cruciate ligament tears in children and adolescents treated without reconstruction has not been established. HYPOTHESIS: N…
英文摘要
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.