gms | German Medical Science

Objectives: A new technique for the treatment of anterior cruciate ligament (ACL) injuries based on the self healing process of the ruptured ligament was introduced at our institution a few years ago.Initially this technique was applied only in adults.

In collaboration with its originator we introduced this new technique in children.

We therefore asked : How are the clinical and radiological results 2 years after this new operation technique.

Methods: Retrospective review of 22 young, sportive patients with an average age of 13 years treated by the dynamic intraligamentary stabilization (DIS) technique immediately (3-15 days) after an anterior cruciate ligament injury. The technique combines an internal dynamic screw-spring mechanism with a braided polyethylene anchoring wire to provide anterior posterior stability of the knee during self-healing of the ligament.

Clinical evaluation of the patients was performed 6 weeks, 3 months, 6 months 12 and 24 months after operation. Assessment included the Lysholm score, the International Knee Document Committee (IKDC) score, the Tegner Activity score and the Peds QL score. Average follow up 2 years.

Radiological follow up included a.p. and lateral radiographs for observation of postoperative changes of the knee in terms of growth arrest after this transphyseal technique.

Results and Conclusion: We observed no surgery-related complications. At 24 months follow up most of the patients showed stable knee joints and were able to return to their usual activity level. All clinical scores improved significantly. Two patients had traumatic reruptures of the ACL and needed reconstruction by a semitendinosus graft. 3 patients had hypertrophic scars requiring re-arthroscopy. No growth disturbances or axial deformities occured.

The dynamic intraligamentary stabilization technique may be a treatment option for an acute traumatic acl rupture in children in special indications.

No adverse events occurred.