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Knee: Pediatric Anterior Cruciate Ligament Reconstruction (Downloadable) Davide E. Bonasia, MD, Torino, Italy Roberto Rossi, MD, Torino, Italy Brian R. Wolf, MD, Iowa City, IA Annunziato Amendola, MD, Iowa City, IA

Video Downloadable File! A credit card is required for payment. List Price: $ 32.00 AAOS Members and Residents: See your exclusive price when you Log In or Add To Cart. Or call 800-626-6726. AAOS Members on Active Military Duty: Order at 800-626-6726 to receive your exclusive price. Item: V11004M Downloadable, 20 mins.

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Area of Focus: Sports Medicine and Hip, Knee & Lower Extremity

Our video begins with a brief introduction outlining the controversies, possible treatments, complications, clinical examination, and imaging of anterior cruciate ligament (ACL) rupture in pediatric patients. We then describe the most commonly used techniques for pediatric ACL reconstruction, which include: physeal-sparing techniques, partial transphyseal techniques, and complete transphyseal techniques. Next the video gives a step-by-step description of pediatric ACL reconstruction using a partial transphyseal technique with proximal over-the-top positioning of the semitendinosus autograft. The 10-step surgical procedure we describe includes: 1) set-up and examination under anesthesia; 2) graft harvesting; 3) graft preparation; 4) arthroscopic knee balance; 5) proximal approach to the lateral femur; 6) over-the-top positioning; 7) tibial-tunnel drilling; 8) proximal fixation of the graft; 9) distal fixation of the graft and final examination of the knee; and 10) postoperative management. Finally, we report the outcomes of conservative and surgical treatments, highlighting the level of evidence of the available studies, the controversies regarding the indications, and the technical errors commonly correlated with growth disturbance.

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