The American journal of knee surgery
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It has been recommended that reconstruction of the anterior cruciate ligament (ACL) in skeletally immature patients should not violate the physeal plate of the distal femur or proximal tibia as growth irregularity might occur. Despite the lack of conclusive evidence that tendon transfers through growth areas cause growth irregularity, recent reports suggest that ligament reconstruction be performed in a nonisometric fashion to avoid violating the growth plate. Eight skeletally immature individuals underwent ligament reconstruction (average age: 14 years 9 months) and were reviewed retrospectively at an average of 32 months postsurgery. ⋯ Ligament reconstruction using the semitendinosus and gracilis autograft can give excellent results in the skeletally immature individual. There appears to be minimal risk to the growth areas of the tibia or the femur at the knee. The graft can be safely passed through anatomically accurate bony drill holes in an arthroscopic fashion without apparent damage.