Management of complete traumatic anterior cruciate ligament tears in the skeletally immature patient: Current concepts and review of the literature

Once considered extremely rare, complete traumatic tears of the anterior cruciate ligament (ACL) in skeletally immature patients with open physes are now being diagnosed with increasing frequency. Concomitant subsequent meniscal injuries develop in a significant number of these patients. Nonoperative treatment, primary surgical repair of the torn ACL, or extraarticular stabilization procedures have not been reported to restore dynamic knee stability or prevent further meniscal damage. Transphyseal bone plugs from a patellar tendon graft fixed with suture or interference screws have not been reported in patients with significant growth potential and cannot be recommended. Soft-tissue autografts placed through transphyseal tunnels have been reported to give good functional results and minimize potential for growth disturbance.