To The Editor:We read the article, "Transepiphyseal Replacement of the Anterior
Cruciate Ligament in Skeletally Immature Patients. A Preliminary Report"
(2003;85:1255-63), by A.F. Anderson. Clearly, the author is attempting to
address a difficult problem in relation to the anterior cruciate-deficient
knee in early adolescence. The mean age in his series was 13.3 ± 1.4
years, which is three to four years prior to epiphyseal closure in the femur
and tibia in boys. By the same token, the epiphysis also has the potential for
growth during this period, and therefore, with time, the consequences for the
graft will be either stretching or, if stretching is not encountered, gradual
tunnel enlargement, particularly on the femoral side.