Paediatric physeal sparing posterior cruciate ligament (PCL) reconstruction with parental donation allograft: Rationale and operative approach

In paediatric patients with persisting symptomatic instability despite appropriate conservative management, surgical reconstruction of the PCL should be considered. Standard treatment has higher complication rates and poorer graft survival than in an adult cohort. Specific problems include iatrogenic growth plate injury causing growth arrest or angular deformity, inadequate graft size if using hamstrings autograft, and the additional technical challenge of small patient size. Early results from extra-physeal, all-inside PCL reconstruction using a parentally donated allograft are promising and may provide an alternative solution to traditional surgical management.