Management of ACL Injuries in the Skeletally Immature

Controversies in the Management of Anterior Cruciate Ligament Injuries in Skeletally Immature Patients

A Literature Review of Current Treatment Options

Amr Selim, MBChB (Hons), MRCS, MSc Orthopaedics; Humza Tariq Osmani, BSc (Hons), MBBS (Dist), MRCS; Wasim Khan, MBChB, MRCS, Dip Clin Ed, MSc, PhD, FRCS(Tr&Orth); Ioannis Pengas, MBChB, MRCS, FRCS (T&O), MPhil (MedLaw & Ethics), MD

Disclosures

Curr Orthop Pract. 2022;33(2):197-203. 

In This Article

Abstract and Introduction

Abstract

Background: Despite an increasing incidence of injury, there continues to be a paucity of literature, when compared with adult cohorts, for anterior cruciate ligament (ACL) disruption in skeletally immature patients. The detrimental long-term effects of chondral or meniscal damage resulting from an ACL deficient and unstable knee, has led most contemporary orthopaedic surgeons to opt for surgical intervention rather than nonoperative management. However, high failure rates in the young and adolescent group after formal ACL reconstruction, along with the potential risks of physeal disturbance, have been highlighted as a cause for concern. The aim of this review was to provide the state of art management of ACL injuries in skeletally immature patients based on the current evidence.

Methods: A literature review on the different management options of ACL injuries in skeletally immature patients was conducted. The authors searched PubMed entries from inception until April 2021. The search was performed with the search terms "ACL injuries" AND "skeletally immature".

Results:A comprehensive search related to the management of "ACL injuries" generated 13,157 results. Thus, search was narrowed to include the term "children" to focus our study on 570 papers. To further refine our search, we included the terms "ACL injuries" AND "skeletally immature," which produced 327 results.

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