John Xerogeanes, MD

New technology has made it possible for surgeons to reconstruct ACL tears in young athletes without disturbing the growth plate, according to a John Xerogeanes, MD, chief of the Emory Sports Medicine Center, Emory University, Atlanta.

The university has developed 3-D MRI technology that allows surgeons to preoperatively plan and perform anatomic anterior cruciate ligament (ACL) surgery.

ACL tears are one of the most common injuries in children who participate in sports including football, basketball, soccer, and gymnastics. Traditional treatment for ACL injuries in kids has been rehabilitation, wearing a brace, and staying out of athletics until the child stops growing–usually in the mid-teens–and ACL reconstruction surgery could then safely be performed.

"The problem with doing surgery on a young child is that if you damage the growth plate, you can cause a growth disturbance," said Xerogeanes, an associate professor in the Department of Orthopaedics at Emory University School of Medicine, in a statement.

To replace the ACL, surgeons create a tunnel in the upper and lower knee bones (femur and tibia), slide the new ACL between those two tunnels, and attach it at both ends.

Xerogeanes said that prior to using the 3-D MRI technology, ACL operations were conducted with extensive use of X-Rays in the operating room, and left too much to chance when working around growth plates.

With this new technology, surgeons can actually see from one point to the other on either side of the knee, and can correctly position the tunnels where they will place the new ligament. The surgery can be done in less time than the traditional surgery, and with confidence that the growth plates in young patients will not be damaged.

Kids who undergo this type of operation will still have at least 1 year of recovery time,  Xerogeanes said. Rehabilitation is performed during that time. The good news is that it does allow them to eventually pursue normal activity.

Xerogeanes and his colleagues at Emory are performing the anatomic ACL reconstruction technique on adult patients as well as pediatric patients. He said he hopes that another advantage of this new anatomical procedure will be that it helps prevent reinjury in the future for all athletes who have suffered from ACL tears.

[Source: Emory University]