Key result
Early ACL reconstruction using techniques to avoid physeal growth disturbance is widely accepted to prevent increased rates of meniscal and chondral injuries associated with delayed management.
Why the study?
With pediatric ACL injuries increasing and evidence showing harms from delayed or nonoperative management, the authors reviewed relevant anatomy, biomechanics, physical examination, imaging, and reconstruction options tailored to skeletal age and growth potential.
Early ACL reconstruction in pediatric patients is now widely accepted to avoid the increased risks of meniscal and chondral injuries associated with delayed or nonoperative management.
Answers are grounded in this paper and cite their sources.
Supports early physeal-sparing ACL reconstruction in skeletally immature patients; leaves open need for prospective RCTs on timing and outcomes.
As youth sports participation has increased in recent years, injuries to the anterior cruciate ligament (ACL) have become increasingly common in pediatric patients. Historically, ACL reconstruction was delayed in pediatric patients to avoid physeal damage with the potential for leg-length discrepancy or angular deformity. Current research shows that delaying reconstruction or choosing nonoperative management is associated with increased rates of meniscal and chondral injuries, persistent knee instability, and low rates of return to previous activity. Early ACL reconstruction using techniques to avoid physeal growth disturbance is now widely accepted among physicians. The purpose of this review was to describe the pediatric ACL in terms of the relevant anatomy and biomechanics, physical examination, and diagnostic imaging. In addition, the importance of skeletal age and possible physeal injury is discussed in the context of ACL reconstruction options by skeletal age and remaining growth potential.
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Rohde et al. (2022) conducted a review in Anterior cruciate ligament (ACL) injuries. Early anterior cruciate ligament (ACL) reconstruction vs. Delayed reconstruction or nonoperative management was evaluated. Early ACL reconstruction using techniques to avoid physeal growth disturbance is widely accepted to prevent increased rates of meniscal and chondral injuries associated with delayed management.
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