Orthopedics Today—September 12, 2012
“Anterior cruciate ligament growth and intercondylar notch growth appeared to slow down prior to longitudinal growth,” Daniel W. Green, MD, FACS, said during his presentation of the observational study at the 13th EFORT Congress 2012. “The majority of the growth occurs prior to age 10. This unique growth pattern of the immature knee may be a relevant risk factor for pediatric anterior cruciate ligament injury and possibly when selecting the graft size for ligament reconstruction in pediatric patients. One could also speculate that, as the notch in the anterior cruciate ligaments matures 3 or 4 years before longitudinal growth, that in itself may be protective.”
Growth of normal structures
To find out how the normal ACL and intercondylar notch change as a function of age, Green and colleagues studied 314 MRIs of 137 children younger than 18 years.
Increases and plateaus
The researchers found that ACL and intercondylar notch volume increased with age, but slowed by age 10 years. Green said growth of the distal femur usually ceases by age 16 years in boys and age 13 years in girls. The study patients’ growth slowed down “prior to longitudinal growth,” Green explained. A multiple pair-wise comparison revealed that intercondylar notch volume plateaued at 10 years of age, Green said.
Green DW, Potter H, Hayter CL, et al. Anterior cruciate ligament and intercondylar notch growth patterns in children: A retrospective MRI study. Paper #12-2740. Presented at the 13th EFORT Congress 2012. May 23-25. Berlin.
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