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MRI Advance Helps With ACL Repair For Kids

January 26, 2011
Written by: , Filed in: Musculoskeletal Radiology, Pediatric Radiology
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New 3-D MRI technology developed at Emory University in Atlanta allows surgeons to replace torn anterior cruciate ligaments in children without disturbing growth plates.

ACL tears have become common injuries for children participating in sports, especially girls. Traditional treatment for still-growing children involves rehabilitation, a knee brace, and avoidance of sports or other high-risk activities until the child stops growing.

“The problem with doing surgery on a young child is that if you damage the growth plate, you can cause a growth disturbance,” said John Xerogeanes, MD, chief of the Emory Sports Medicine Center. He was quoted in an Emory news release.

Dr.  Xerogeanes, who is also an associate professor in the orthopedics department at Emory School of Medicine, and colleagues in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University developed new MRI technology to solve the problem.

ACL replacement, almost always done arthroscopically, involves drilling tunnels in the femur and tibia, threading the new ACL through the tunnels, and attaching it to the bone at each end. The new ligament is usually either a hamstring or patellar tendon from the patient or a donor ligament from a cadaver.

Before the new MRI technology, Dr. Xerogeanes said, surgeons used X-rays in the operating room to guide them, but the images weren’t comprehensive enough to allow working around growth plates with confidence.

The new technology, he said, lets surgeons see both sides of the knee at once, allowing them to position the tunnels where they will not damage growth plates. The 3-D MRI also shortens surgery time.

Children who undergo the surgery will still need at least a year of recovery time, Dr. Xerogeanes said, but they can resume their normal activities after that.

He and his colleagues at Emory are using the technique for adult ACL surgery as well. He said he hoped that the greater precision the MRI images allow might help prevent reinjury.

Related seminar: Sports Medicine Imaging

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