{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T03:35:27Z","timestamp":1788320127983,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,10,26]],"date-time":"2014-10-26T00:00:00Z","timestamp":1414281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,10,26]],"date-time":"2014-10-26T00:00:00Z","timestamp":1414281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Reconstruction of the anterior cruciate ligament (ACL) remains a major concern in the prepubescent, skeletally immature patient with wide open growth plates. Different surgical techniques have been proposed. This study reports the results and complications of ACL reconstruction in young children using an all epiphyseal technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2006 and 2010, 12 patients (10\u201313 years, median 12.1 years) underwent epiphyseal primary ACL reconstruction, with a total of 13\u00a0knee procedures. Patients were assessed retrospectively with a median follow\u2010up of 54\u00a0months (range 39\u201380\u00a0months) consisting of a clinical examination, instrumented arthrometer testing and radiological analysis. Functional status was assessed using the Lysholm knee score, Tegner activity scale and IKDC\u20102000 form.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to the IKDC examination form, five knees were rated as normal, six near normal and two abnormal. The median IKDC score at follow\u2010up was 88.5 points (range 75\u201399 points). The mean side\u2013to\u2010side difference in KT\u20101000 ligament laxity testing was 1.5\u00a0mm (\u00b12.5\u00a0mm). In two patients, reoperation was necessary due to graft failure. Two patients developed significant leg length inequality; one with 20\u00a0mm overgrowth and varus malalignment after re\u2010reconstruction and the second developed arthrofibrosis and overgrowth of 16\u00a0mm. Four patients had minor limb length discrepancy ranging between +5 and +10\u00a0mm; no growth arrest was noted. One patient with an intact but slightly elongated graft required a meniscal suture 34\u00a0months after ACL reconstruction following a traumatic medial meniscal lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite using the epiphyseal technique in ACL reconstruction, relevant growth discrepancy can occur. Thereby, overgrowth rates appear to potentially pose a major clinical problem, which has remained unreported so far. Overall, there is a considerable high risk of complications in this patient group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-3396-4","type":"journal-article","created":{"date-parts":[[2014,10,25]],"date-time":"2014-10-25T03:38:57Z","timestamp":1414208337000},"page":"2736-2740","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Complications after epiphyseal reconstruction of the anterior cruciate ligament in prepubescent children"],"prefix":"10.1002","volume":"24","author":[{"given":"Peter P.","family":"Koch","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology Kantonsspital Winterthur Postfach 834, Brauerstrasse 15 8401 Winterthur Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro 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