DOS Kongressen 2014 ·
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Treatment of posterior cruciate ligament tear
combined with postero-lateral instability in skeletal
immature children.
Ole Gade Sørensen, Peter Faunø, Svend Erik Christiansen, Martin Lind
Orthopedics, University hospital of Århus
Background:
Tear of the posterior cruciate ligament (PCL) in combination with
instability of the postero-lateral corner (PLC) is a very uncommon finding in
children with open growth plates. We present follow- up results of three pa-
tients with open physes treated with PCL and PLC reconstruction.
Purpose / Aim of Study:
To evaluate clinical outcome after combined PCL and
PLC reconstruction in three skeletal immature patients.
Materials and Methods:
Between July 2004 and December 2010 three skel-
etal immature patients were treated with combined PCL and PLC reconstruc-
tion. Age at time of surgery was 7, 7 and 9 years. At follow-up the three pa-
tients were 16, 15 and 13 years respectively. Outcome was evaluated by KOOS
and Tegner scores, Instrumented knee laxity and radiologic long axis leg length
measurements.
Findings / Results:
KOOS scores at follow up for patient# 1, regarding symp-
toms, pain, ADL, Sport, and QOL were 61, 64, 66, 15 and 38. Patient# 2 scores
were 86, 100, 100, 100 and 100, whereas patient#3 scored 96, 94, 100, 95
and 81 respectively. Tegner score was 6, 9 and 6 for the three patients. Laxity
measurement was only performed for patient#1 and patient#2 at follow-up.
Side to side difference in laxity using KT1000 was 0 and 2 mm at 25 degrees of
flexion and 1 and 8 mm at 70 degrees of flexion. Side to side difference in knee
flexion was 15, 5 and 5 degrees. No difference in knee extension was found. At
follow-up all three patients had returned to sports at a recreational level. Leg
length discrepancy was found to be 11, 16 and 5 mm, the index knee being the
longer in all three patients.
Conclusions:
Combined PCL and PLC reconstruction seems to result in vari-
able clinical outcome in skeletal immature children and our data suggest a risk of
growth disorder in these patients.
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