{"id":4464,"date":"2026-05-12T18:36:00","date_gmt":"2026-05-12T16:36:00","guid":{"rendered":"http:\/\/stocks-future.com\/?guid=5a93dea4581c8dca6db21bd482fe450c"},"modified":"2026-05-12T18:36:00","modified_gmt":"2026-05-12T16:36:00","slug":"hss-research-supports-routine-imaging-before-and-after-acl-surgery-in-growing-children","status":"publish","type":"post","link":"https:\/\/stocks-future.com\/?p=4464","title":{"rendered":"HSS Research Supports Routine Imaging Before and After ACL Surgery in Growing Children"},"content":{"rendered":"

ORLANDO, Fla.--(BUSINESS WIRE)--At this year\u2019s Pediatric Orthopedic Society of North America<\/a> (POSNA) annual meeting, researchers at Hospital for Special Surgery (HSS) presented two studies evaluating outcomes for three of the most common anterior cruciate ligament (ACL) reconstruction techniques designed to protect open growth plates in young patients who are still growing. The findings highlight the importance of using imaging before and after surgery to accurately identify and monitor alignment issues and capitalize on opportunities for early intervention.<\/p><\/a><\/a>

\nWhat follows are highlights from these studies:<\/i><\/p>

\nUse of Imaging to Identify Alignment Issues in Pre-Pubertal Children After ACL Reconstruction<\/b><\/p>

\nA new multi-center prospective study from researchers at HSS evaluated two specialized surgical reconstruction techniques commonly used to treat ACL injuries by restoring knee stability while minimizing risks of growth disturbances in children with open growth plates (skeletally immature) and more than two years of growth remaining.<\/p>

\nResearchers compared changes in lower extremity alignment among 112 pre-pubescent patients (girls younger than 12 and boys younger than 14) who had either a physeal-sparing combined intra\/extra-articular reconstruction with iliotibial band (ITB) autograft (77 patients) or an all-epiphyseal reconstruction (35 patients). All patients had x-rays taken before surgery and again one year after surgery to measure and compare growth changes in both legs.<\/p>

\nThey found that approximately 25% of children in the study developed subtle postoperative changes such as differences in leg length and angular deformity that could raise their risk of reinjury in the future. However, there were fewer growth disturbances among older patients who had less than two years of growth remaining.<\/p>

\n\u201cIt\u2019s important to make people aware that even though these procedures are safe overall and designed to respect the growth plates, there is still a risk of kids experiencing alignment issues afterward,\u201d says Peter D. Fabricant, MD, MPH<\/a>, pediatric orthopedic surgeon at HSS and senior author of the study.<\/p>

\nAn ACL injury is a painful tear or sprain of the ligament connecting the femur (thighbone) to the tibia (shinbone). These injuries have become common among physically active children, especially with year-round participation in sports and an increased level of competition.<\/p>

\nIn adult patients, the standard ACL reconstruction technique involves drilling tunnels in the femur and tibia to secure a new ligament. For children who are still growing, the growth plates\u2014where the bones grow and gain length\u2014are exactly where the surgeon would need to drill those tunnels. That is why alternative surgical techniques have been developed that reconstruct the ACL and minimize damage to the growth plate in young patients.<\/p>

\n\u201cIf you injure the growth plate in a younger child who has many years to grow, there\u2019s a lot of time during which that growth plate can grow abnormally,\u201d explains Dr. Fabricant. \u201cPrepubertal patients are the most vulnerable population for growth plate injury, so this study focused on that subset of patients to determine the incidence of developing deformity after surgery.\u201d<\/p>

\nThis is the first multicenter study to rigorously assess leg alignment before and after surgery and compare the surgical leg to the uninjured leg to identify and monitor postoperative growth disturbances. Such changes may not be reliably measured with clinical examination alone.<\/p>

\n\u201cThis study gives evidence to support the use of imaging to routinely check a patient\u2019s alignment before surgery, check it after surgery, and monitor these kids for growth disturbances so that we can intervene in minimally invasive ways while they are still growing,\u201d explains Dr. Fabricant. \u201cThis is important because only checking alignment when there is a concern is very subjective and there may be missed opportunities for early intervention.\u201d<\/p>

\nOne minimally invasive surgical technique used to correct alignment issues is called implant-mediated guided growth. This involves placing implants around the growth plate that guide it to grow in a way that encourages realignment. The technique avoids the need for a much bigger operation (osteotomy) to realign the bone and a lengthy recovery, as would be the case for an adult.<\/p>

\n\u201cYou can only do guided growth surgery when the growth plate is still actively growing, which for some of these kids is only a year or two after their surgery,\u201d explains Dr. Fabricant. \u201cIf you aren\u2019t routinely imaging to monitor alignment and you don\u2019t realize it in time, then you\u2019re beyond that window of being able to do that minimally invasive surgery.\u201d<\/p>

\nUse of Imaging to Identify Alignment Issues in Adolescent Children With Open Growth Plates After ACL Reconstruction<\/b><\/p>

\nA second study led by researchers at HSS found that 15% to 30% of adolescent patients who had ACL reconstruction with soft-tissue autograft developed changes in leg alignment, but no patients developed growth-related complications requiring intervention.<\/p>

\nFor adolescent patients who still have open growth plates and less than two years of growth remaining, ACL reconstruction with soft-tissue autograft is often the technique of choice. This procedure involves drilling tunnels in the bone that would be similar to an adult ACL reconstruction, but the surgeon uses a graft and implants that don\u2019t typically affect the growth plate.<\/p>

\n\u201cEven though this procedure is largely safe for adolescents, there is still a possibility of alignment changes after surgery,\u201d notes Peter D. Fabricant, MD, MPH<\/a>, pediatric orthopedic surgeon at HSS and senior author of the study. \u201cThis study adds more evidence to support the need to take x-rays before and after surgery and monitor this population until they reach skeletal maturity.\u201d<\/p>

\nThe prospective multicenter study included 99 patients (50 boys and 49 girls with a median age of about 14 years) who had less than two years of growth remaining and underwent a primary transphyseal ACL reconstruction with soft-tissue autograft. Researchers used x-ray imaging before surgery and one year after surgery to measure and compare differences in leg alignment.<\/p>

\n\u201cWe know that leg alignment is a vital factor in predicting injury, reinjury, and surgical failure, so measuring alignment preoperatively is extremely important because you gain the opportunity to address alignment issues at the same time as the ACL surgery with no additional risk,\u201d explains Dr. Fabricant.<\/p>

\nFor example, if a patient is found to have a borderline alignment issue before surgery, some surgeons may be encouraged to perform an implant-mediated guided growth surgery at the same time as the ACL reconstruction because they know that there is a risk of potentially worsening post-operative alignment if they don\u2019t.<\/p>

\n\u201cThe logical next step is to strongly consider intervening on alignment problems when necessary in order to prevent reinjury,\u201d says Dr. Fabricant.<\/p>

\nAbout HSS<\/b><\/p>

\nHSS is the world\u2019s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 16th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2024-2025), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report \u201cBest Children\u2019s Hospitals\u201d list (2025-2026). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu<\/a>.<\/p> Contacts<\/b>

\nTracy Hickenbottom\/Rachael Rennich\n212-606-1197\nmediarelations@hss.edu<\/a><\/p>","protected":false},"excerpt":{"rendered":"

ORLANDO, Fla.–(BUSINESS WIRE)–At this year\u2019s Pediatric Orthopedic Society of North America (POSNA) annual meeting, researchers at Hospital for Special Surgery (HSS) presented two studies evaluating outcomes for three of the most common anterior cruci…<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4464","post","type-post","status-publish","format-standard","hentry","category-infos-businesswire"],"_links":{"self":[{"href":"https:\/\/stocks-future.com\/index.php?rest_route=\/wp\/v2\/posts\/4464","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stocks-future.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stocks-future.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stocks-future.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/stocks-future.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4464"}],"version-history":[{"count":1,"href":"https:\/\/stocks-future.com\/index.php?rest_route=\/wp\/v2\/posts\/4464\/revisions"}],"predecessor-version":[{"id":4465,"href":"https:\/\/stocks-future.com\/index.php?rest_route=\/wp\/v2\/posts\/4464\/revisions\/4465"}],"wp:attachment":[{"href":"https:\/\/stocks-future.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4464"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stocks-future.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4464"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stocks-future.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4464"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}