Abstract
Anterior cruciate ligament tears in skeletally immature patients are being reported with increasing frequency. Management options for these injuries include nonoperative, early surgical reconstruction, or delayed surgical reconstruction. There is a growing body of evidence that demonstrates nonoperative or delayed reconstruction results in higher rates of recurrent instability, increased meniscal and chondral injury, and worse functional outcomes compared to early reconstruction. Current ACL reconstruction techniques minimize the risk of growth disturbance and are effective at preventing recurrent instability and restoring normal function. Based on the current literature, reconstruction within 6–12 weeks from the time of the injury has been shown to decrease associated knee pathology and improve functional outcomes.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aichroth PM, Patel DV, Zorrilla P (2002) The natural history and treatment of rupture of the anterior cruciate ligament in children and adolescents: a prospective review. J Bone Joint Surg (Br) 84:38–41
Anderson AF (2003) Transepiphyseal replacement of the anterior cruciate ligament in skeletally immature patients: a preliminary report. J Bone Joint Surg Am 85:1255–1263
Anderson AF, Anderson CN (2015) Correlation of meniscal and articular cartilage injuries in children and adolescents: timing. ACL Reconstr Am J Sports Med 43(2):275–281
Dumont G, Hogue G, Podalecki J (2012) Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: relationship of treatment time and patient-specific factors. Am J Sports Med 40(9):2128–2133
Frosch KH, Stengel D, Brodhun T et al (2010) Outcomes and risks of operative treatment of rupture of anterior cruciate ligament in children and adolescents. Arthroscopy 26:1539–1550
Fundahashi KM, Moksnes H, Maletis GB et al (2014) Anterior cruciate ligament injuries in adolescents with open physes: effect of recurrent injury and surgical delay on meniscal and cartilage injuries. Am J Sports Med 42(5):1068–1073
Graf BK, Lange RH, Fujisaki CK et al (1992) Anterior cruciate ligament tears in skeletally immature patients: meniscal pathology at presentation and after attempted conservative treatment. Arthroscopy 8:229–233
Guenther Z, Swami V, Dhillon S, Jaremko J (2014) Meniscal injury after adolescent anterior cruciate ligament injury: how long are patients at risk? Clin Orthop Relat Res 472:990–997
Henry J, Chotel F, Chouteau J et al (2009) Rupture of the anterior cruciate ligament in children: early reconstruction with open physes or delayed reconstruction to skeletal maturity? Knee Surg Sports Traumatol Arthrosc 17:748–755
Janarv PM, Nystrom A, Werner S, Hirsch G (1996) Anterior cruciate ligament injuries in skeletally immature patients. J Pediatr Orthop 16:673–677
Kannas P, Jarvinen M (1988) Knee ligament injury in adolescents, eight year follow-up of conservative management. J Bone Joint Surg 70:772–776
Kocher MS, Saxon HS, Hovis WD et al (2002) Management and complications of anterior cruciate ligament injuries in skeletally immature patients: survey of the Herodicus Society and the ACL Study Group. J Pediatr Orthop 22:452–457
Koman JD, Sanders JO (1999) Valgus deformity after reconstruction of the anterior cruciate ligament in skeletally immature patients: a case report. J Bone Joint Surg Am 81:711–715
Lawrence JT, Argawal N, Ganley TJ (2011) Degeneration of the knee joint in skeletally immature patients with a diagnosis of an anterior cruciate ligament tear: is there harm in delay of treatment? Am J Sports Med 39(12):2582–2587
Lipscomb AB, Anderson AF (1986) Tears of the anterior cruciate ligament in adolescents. J Bone Joint Surg Am 68:19–28
McCarroll JR, Rettig AC, Shelbourne KD (1988) Anterior cruciate ligament injuries in the young athlete with open physes. Am J Sports Med 16:44–47
Millett PJ, Willis AA, Warren RF (2002) Associated injuries in pediatric and adolescent anterior cruciate ligament tears: does a delay in treatment increase the risk of Meniscal Tear? Arthroscopy 18:955–959
Mizuta H, Kubota K, Shiraishi M et al (1995) The conservative treatment of complete tears of the anterior cruciate ligament in skeletally immature patients. J Bone Joint Surg (Br) 77:890–894
Moksnes H, Engebretsen L, Risberg MA (2013) Prevalence and incidence of new meniscus and cartilage injuries after a nonoperative treatment algorithm for ACL tears in skeletally immature children: a prospective MRI study. Am J Sports Med 41(8):1771–1779
Moksnes H, Engebretsen L, Risberg MA (2008) Performance-based functional outcome for children 12 years or younger following anterior cruciate ligament injury: a two to nine-year follow-up study. Knee Surg Sports Traumatol Arthrosc 16:214–223
Newman JT, Carry PM, Terhune B et al (2015) Factors predictive of concomitant injuries among children and adolescents undergoing anterior cruciate ligament surgery. Am J Sports Med 43(2):282–288
Pressman AE, Lets RM, Jarvis JG (1997) Anterior cruciate ligament tears in children: an analysis of operative versus nonoperative treatment. J Pediatr Orthop 17:505–511
Ramski D, Franklin C, Baldwin K, Ganley T (2014) Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med 42(11):2769–6
Vavken P, Murray M (2011) Treating anterior cruciate ligament tears in skeletally immature patients. Arthroscopy 27(5):704–716
Woods GW, O’Connor DP (2004) Delayed anterior cruciate ligament reconstruction in adolescents with open physes. Am J Sports Med 32:201–210
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 ISAKOS
About this chapter
Cite this chapter
Anderson, A.F., Anderson, C.N. (2017). Timing of Pediatric ACL Reconstruction. In: Nakamura, N., Zaffagnini, S., Marx, R., Musahl, V. (eds) Controversies in the Technical Aspects of ACL Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52742-9_6
Download citation
DOI: https://doi.org/10.1007/978-3-662-52742-9_6
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-52740-5
Online ISBN: 978-3-662-52742-9
eBook Packages: MedicineMedicine (R0)