Anterior Cruciate Ligament Lesions in Adolescent
ACL injury risk in young athletes is probably multifactorial. Although ACL injury rates increase with age in both genders, girls have higher rates immediately after their growth spurt.
The management of ACL deficiency in skeletally mature children is still controversial, especially in terms of operative timing and surgical technique. Conservative management is not recommended, as it is accompanied by marked reduction in activity, decline in functional performance, and development of early osteoarthritis.
The present trend favors early reconstruction, using either extraphyseal techniques in very young athletes or anatomical reconstruction techniques placing the tibial and femoral tunnels close to the center on the growth plate of the tibia and femur in young athletes closer to skeletal maturity. No consensus exists on the best method to treat an ACL tear in a pediatric athlete. Safe and effective surgical techniques continue to evolve. However, the current literature suggests reasonable, evidenced-based management options that minimize the risks of iatrogenic growth plate injury. The two principal ACL surgery techniques performed on a pediatric athlete are physeal spearing or transphyseal and all-inside.
The authors evaluated, in a group of adolescents, the onset of varus-valgus deviations in the sagittal plane after performing a transtibial transepiphyseal technique of ACL reconstruction with a follow-up of at least 2 years.
The transtibial transepiphyseal technique of ACL reconstruction, according to the results obtained, seems to be a valid alternative procedure, when performed by a skilled orthopedic surgeon, offering an excellent safety profile and at the same time very good clinical results.
KeywordsACL tear Adolescent Soccer Pediatric Surgery
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