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Anterior Cruciate Ligament Injury in Paediatric and Adolescent Patients

A Review of Basic Science and Clinical Research

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Abstract

Anterior cruciate ligament (ACL) injuries are recognised with greater frequency in children and adolescents. Non-operative treatment of ACL injuries in children may lead to knee instability and secondary injuries, especially in those who return to sports. ACL reconstruction is controversial in skeletally immature patients because of potential damage to the proximal tibial and distal femoral physes, which may lead to premature arrest and/or leg length discrepancies. This paper reviews studies of ACL injuries in children and adolescents, and examines basic science and clinical studies concerning physeal arrest secondary to ACL reconstruction tunnels. Some animal studies support the conclusion that ACL reconstructions in children have the potential to cause growth disturbances, and there are reports of growth plate complications due to ACL reconstruction in skeletally immature patients. There is evidence that ACL reconstruction can be performed in select skeletally immature patients, but the risk of growth plate complications must be considered.

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Acknowledgements

No funding was used to assist in the preparation of this manuscript and there are no conflicts of interest with respect to any of the authors and the information presented in this paper.

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Authors and Affiliations

  1. Intermountain Orthopaedics, 600 N. Robbins Rd., Boise, Idaho, 83702, USA

    Kevin G. Shea & Peter J. Apel

  2. Department of Kinesiology, Boise State University, Boise, Idaho, USA

    Ronald P. Pfeiffer

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  1. Kevin G. Shea
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  2. Peter J. Apel
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  3. Ronald P. Pfeiffer
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Correspondence to Kevin G. Shea.

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Shea, K.G., Apel, P.J. & Pfeiffer, R.P. Anterior Cruciate Ligament Injury in Paediatric and Adolescent Patients. Sports Med 33, 455–471 (2003). https://doi.org/10.2165/00007256-200333060-00006

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