ACL & PCL reconstruction in an adolescent child at Ahmedabad , INDIA

Children ligament injuryA 16 years old & weighing 110 kgs Female doing kickboxing from Punjab was referred to Aash arthroscopy center with an unstable painful knee due to one month old injury. Before this injury she was able to do all activities including participating in a state-level Kickboxing championship.

Clinical examination revealed that she had not only ruptured her Anterior cruciate ligament (ACL) but also stretched her Posterior cruciate ligament [PCL- Back ligament of the knee]. Stress X-rays & MRI confirmed this diagnosis including additional injury to her MCL. Fortunately x-rays showed that her growth plates had already fused at 16 years of age so chances of her growth disturbance were almost nil

ACL was reconstructed using Bone- patella tendon- Bone graft considering her high BMI and activity. B-PT-B graft has given excellent results for last 20 years. PCL was reconstructed  (augmented) using semitendinosus graft. Both the grafts were harvested from the same limb with small incisions to give  cosmetic scars to this young lady. Fortunately her menisci as well as articular cartilage  (grease) were normal.

She was advised to keep the non-weight bearing for 3 weeks but her knee bending was started after 5 days. She was advised physiotherapy under the care of a physiotherapist at her native place in Punjab. She was also advised to reduce max. possible weight rapidly. Return to sporting activities will be deferred till 6 to 9 months

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