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Anatomic review reveals age-dependent variations around the knee physes in pediatric patients, highlighting the need for tailored surgical approaches during ACL reconstruction.
Anterior Cruciate Ligament (ACL) injuries in pediatric patients are rising and present unique challenges for orthopedic surgeons due to skeletal immaturity and risk for physeal damage during ACL reconstruction. This review aims to share insights from pediatric cadaveric anatomic studies and related research to inform surgical management of ACL injuries in skeletally immature patients. We highlight age-dependent variations in the distances between the ACL and medial collateral ligament and their respective physes, developmental variability in the anterolateral structures of the pediatric knee, and variability in the proximity of the neurovascular bundle's proximity to the iliotibial band graft pathway during ACL reconstruction. In addition, we review biomechanical properties of different grafts to assess their strength and suitability for ACL reconstruction. Our findings emphasize the importance of age-specific surgical approaches that consider individual anatomic differences of pediatric patients, collectively advancing our understanding of pediatric knee anatomy and its relevance to successful ACL reconstruction.
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Alayleh et al. (2024) studied this question.
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