THE EFFECT OF DRILLING AND SOFT-TISSUE GRAFTING ACROSS OPEN GROWTH PLATES - A HISTOLOGIC-STUDY

We examined the ability of a soft tissue graft to inhibit the formatio n of a bony bridge within tunnels drilled across open femoral and tibi al growth plates in a canine model. A fascia lata autograft was placed in tunnels drilled across the distal femoral and proximal tibial phys es in four skeletally immature dogs. Four additional dogs had a simila r procedure performed, but the drill holes were left empty. The growth plates were evaluated at either 2 weeks or 4 months postoperatively u sing high-resolution radiography and routine histologic study. A bony bridge spanned the growth plate in all nongrafted animals as early as 2 weeks postoperatively. However, the fascia lata autograft prevented bone formation within the tunnels of all grafted animals, which mainta ined normal growth plate anatomy throughout the length of the study. T he results of this study demonstrate that a soft tissue graft of fasci a lata placed in drill holes across open growth plates will prevent th e formation of a bony bridge. These findings provide basic science sup port to those clinical studies that report no apparent alteration in g rowth plate function after the use of intraarticular techniques to rec onstruct the anterior cruciate ligament in children and adolescents.