Table 5.
Summary of outcomes for transphyseal reconstruction
| Author | n | Age at operation, yrs (range) | Treatment, TRANS/EXTRA physeal (fixation) | Mean outcome score (range/sd) | Mean LLD/coronal plane malalignment (range) | Complications |
| Lo et al,11 1997 | 5 | 12.9 (8 to 14) | HYBRID: tibia transphyseal vertical (native), femur extra physeal (staple) | IKDC: 4A, 1C | LLD: -0.8 mm (-5 to +4) 1° (-2° to +3°) |
1 osteochondral fracture (low IKDC) |
| Seon et al,30 2005 | 11 | 14.7 (13.1 to 15.5) | TRANS: tibia (interference screw), femur (screw/staple) | Lysholm 97.8 | LLD: +3.9 mm (-10 to 10) 0.1° (-1° to +1°) |
None reported |
| Mcintosh et al,31 2006 | 16 | 13.8 (11.2 to 14.9) | TRANS: tibia (screw), femur (suspensory) | Lysholm: 90 (74 to 94) Tegner: 8.1 (7 to 9) IKDC: 99 (94 to 100) |
LLD: 6.2 mm (2 to 15). 1 case: +15 mm LLD (shoe raise) No malalignment |
2 graft ruptures (1 revision) 3 failed meniscal repair |
| Courvoisier et al,13 2010 | 37 | 14 (11 to 15) | TRANS: tibia (interference screw), femur (suspensory) | IKDC: 28 A, 4 B, 5 D | No LLD (not quantified) 1° (sd 1.5°) |
3 graft ruptures (revised) 2 revisions for instability |
| Kopf et al,32 2010 | 14 | 14.4 (11 to 16) | TRANS: tibia (staples), femur (suspensory) | Lysholm: 96 (IQ 93 to 100) IKDC: 95 (92 to 98) 8A 5B 1C |
No clinical LLD No malalignment |
None reported |
| Streich et al,3 2010 | 16 | 11 (9 to 12) | TRANS: tibia (staple), femur (suspensory) | Lysholm: 93 Tegner: 7 (6 to 8), IKDC: 95 |
LLD: +1.7 mm (sd 6.6) No malalignment |
None Reported |
| Kumar et al,12 2013 | 32 | 11.25 (9.5 to 14) | TRANS: tibia (screw), femur (suspensory) | Lysholm: 95.86 Tegner: 7.66 |
1 case: 7.1° valgus with LLD -1.6 mm | 1 graft rupture |
| Calvo et al,33 2014 | 27 | 13 (12 to 16) | TRANS (vertical tunnels): tibia (interference/staples tanner 2/3), femur (button, suspensory) | Lysholm: 94 (55 to 100) Tegner: 6 (3 to 9) IKDC 92 (44 to 100) |
LLD: +1.6 mm (-4 to 8) 3.6° valgus (3.4° to 4.3°) (4.05° control leg) | 4 revisions (3 graft ruptures, 1 instability) 2 osteochondral fractures 1 meniscal tear |
| Falciglia et al,35 2016 | 33 | 12.4 (10 to 14.2) | TRANS: tibia (native), femur (staple) | IKDC 10 year: 88.2 (8.4 to 97.7) Skeletal maturity: 91.8 (68.9 to 97.7) |
LLD: femur -1 mm (-5 to +3), tibia +0.2 mm (-0.6 to +0.6) No malalignment |
2 graft ruptures (not re-operated) 1 Kellgren and Lawrence grade 2 |
| Domzalski et al,36 2016 | 22 | 12 (10.5 to 13.2) | TRANS: tibia (screw), femur (screw) | Lysholm 95.9 (94 to 100) Tegner 7 IKDC 14 A, 7 B, 1 C |
LLD: +2 mm (0 to +8), 5 > 5 mm No malalignment |
None reported |
| Dei Giudici et al,37 2016 | 19 | 13.9 (12 to 16) | TRANS: tibia (interference screw), femur (unclear) | Lysholm: 84.6 (40 to 100) Tegner: 8.2 (7 to 10) IKDC: 84 (29.9 to 100) |
1 case: +15 mm LLD | 2 persistent instability (both failed to return to sports) |
| Placella et al,34 2016 | 24 | 13.15 (9 to 14) | TRANS: tibia (interference screw), femur (suspensory) | Lysholm: 100 Tegner: 8.7 IKDC: 98.58 (95.4 to 100) |
LLD: + 4 mm (2 to 7) No malalignment |
10 contralateral ACL, 5 meniscal tears (repaired) |
IKDC, International Knee Documentation committee; LLD, Leg Length Discrepancy