From July 1988 to August 1989, six children with open physes and injur
ies to the anterior cruciate ligament were treated operatively. All in
juries involved twisting episodes during sports activities. Ail six pa
tients had meniscal abnormalities, and, additionally, one patient sust
ained a Grade III medial ligament tear and had a lateral patellar disl
ocation. Operative reconstruction used hamstring tendons and placed a
groove over the front of the tibia and a groove over the top of the fe
mur without violation of the growth plates. The anterior cruciate liga
ment was primarily repaired (three patients) at the time of reconstruc
tion, if possible. At 3 months, one patient underwent arthroscopic res
ection of adhesions for arthrofibrosis. There were no other complicati
ons. Five patients were evaluated with clinical examination, radiograp
hs, magnetic resonance imaging, and functional testing at an average f
ollowup of 33.2 months (range, 25 to 38). Four of the five had returne
d to their preinjury level of sports participation. Manual maximum KT-
1000 arthrometer side-to-side differences averaged 3.6 +/- 1.9 mm. The
average Lysholm knee score was 95.2 +/- 2.5; the average Hospital for
Special Surgery knee score was 96.6 +/- 2.3. There were no growth pla
te injuries. Despite the overall clinical stability, magnetic resonanc
e image scans of the five patients consistently demonstrated areas of
increased signal in the anterior cruciate ligament grafts.