All Inside Intraepiphyseal ACL Reconstruction Using Flexible Curved Instrumentation and Intraoperative Fluoroscopy in a Skeletally Immature Patient | Zendy

Richard N. Puzzitiello | Zendy; Avinesh Agarwalla | Zendy; Grant H. Garcia | Zendy; Enrico M. Forlenza | Zendy; Brian Forsythe | Zendy

Open Access

All Inside Intraepiphyseal ACL Reconstruction Using Flexible Curved Instrumentation and Intraoperative Fluoroscopy in a Skeletally Immature Patient

Author(s) -

Richard N. Puzzitiello,

Avinesh Agarwalla,

Grant H. Garcia,

Enrico M. Forlenza,

Brian Forsythe

Publication year - 2021

Publication title -

case reports in orthopedics

Language(s) - English

Resource type - Journals

eISSN - 2090-6749

pISSN - 2090-6757

DOI - 10.1155/2021/3956524

Subject(s) - medicine , fluoroscopy , physis , anterior cruciate ligament , anterolateral ligament , instrumentation (computer programming) , surgery , drill , anterior cruciate ligament reconstruction , radiography , computer science , materials science , metallurgy , operating system

Case A 13-year-old skeletally immature female presenting with an anterior cruciate ligament (ACL) rupture after a noncontact injury was treated with an intraepiphyseal ACL reconstruction. Flexible instrumentation was utilized to drill a femoral tunnel with an anatomic starting point, with a trajectory that curved inferolaterally away from the physis. At three years postoperatively, she had returned to her preinjury functioning and did not display any lower limb length growth abnormalities.Conclusions The novel application of curved guides and flexible instruments, with intraoperative fluoroscopy, facilitated growth plate avoidance and a successful outcome of ACL reconstruction in a skeletally immature patient.

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