Anterior cruciate ligament injuries in the skeletally immature athlete: diagnosis and management

J Am Acad Orthop Surg. 2013 Feb;21(2):78-87. doi: 10.5435/JAAOS-21-02-78.

Abstract

Intrasubstance anterior cruciate ligament (ACL) injuries in children and adolescents were once considered rare occurrences, with tibial eminence avulsion fractures generally regarded as the pediatric ACL injury equivalent. However, with increased single-sport focus, less free play, and year-round training at younger ages, intrasubstance ACL injuries in children and adolescents are being diagnosed with increased frequency. As in the adult, a knee devoid of ligamentous stability predisposes the pediatric patient to meniscal and chondral injuries and early degenerative changes. Management of ACL injuries in skeletally immature patients includes physeal-sparing, partial transphyseal, and complete transphyseal ACL reconstruction. Complications include iatrogenic growth disturbance resulting from physeal violation.

Publication types

  • Review

MeSH terms

  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Arthroscopy / methods
  • Athletic Injuries / diagnosis*
  • Athletic Injuries / surgery
  • Humans
  • Knee Injuries / diagnosis*
  • Knee Injuries / surgery
  • Magnetic Resonance Imaging