ANTERIOR CRUCIATE LIGAMENT INJURIES IN SKELETALLY IMMATURE PATIENTS

Twenty-eight consecutive, skeletally immature patients (9.9-15.0 years of age at the time of injury) with total rupture of the anterior cruc iate ligament (ACL) were followed up for 3-5 years. The aims of the st udy were to monitor the natural course of conservative treatment, to i dentify variables relevant to failure of conservative treatment, and t o evaluate an over-the-top procedure for ACL reconstruction by using t he semitendinosus tendon and avoiding the physes. The patients were in terviewed according to Lysholm knee score and Tegner activity level. K nee laxity and muscle torque were measured. Five patients insisted on immediate reconstruction. Twenty-three patients were sent to a 3-month rehabilitation program. Sixty-eight percent of the patients, who made an attempt with conservative treatment, had been operated on at follo w-up. The patients not operated on were younger at injury and had a lo wer activity level at follow-up. The surgical procedure improved objec tive and subjective knee function, but there was a correlation between high activity level and a low Lysholm score.