Skip to main content

Pediatric ACL Injuries: Treatment and Challenges

  • Chapter
ESSKA Instructional Course Lecture Book

Abstract

The number of publications on treatment of anterior cruciate ligament (ACL) injuries in the skeletally immature population has increased through the past decade [1–6]. However, opinions on whether pediatric ACL injuries should primarily be surgically reconstructed or conservatively treated are still divided within the pediatric orthopedic community [7, 8]. Evidence from high-level studies and randomized controlled trials is lacking [9], which leaves the field open for various treatment algorithms due to the lack of a solid scientific knowledge base. Risk factors for ACL injuries in skeletally immature patients are unknown, although it seems that boys may be more prone to rupturing their ACL before skeletal maturity, while girls have an increased risk through and after puberty [10, 11]. Many authors argue that the incidence of pediatric ACL injuries is rising. However, no epidemiological studies are available to support this statement. Increased awareness and advances in diagnostic methods, in addition to higher participation rates and earlier specialization in sports, may have led to an increase in the incidence of pediatric ACL tears.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 149.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Calvo R, Figueroa D, Gili F, Vaisman A, Mococain P, Espinosa M, Leon A, Arellano S. Transphyseal anterior cruciate ligament reconstruction in patients with open physes: 10-year follow-up study. Am J Sports Med. 2015;43:289–94.

    Article  Google Scholar 

  2. Demange MK, Camanho GL. Nonanatomic anterior cruciate ligament reconstruction with double-stranded semitendinosus grafts in children with open physes: minimum 15-year follow-up. Am J Sports Med. 2014;42:2926–32.

    Article  Google Scholar 

  3. Goddard M, Bowman N, Salmon LJ, Waller A, Roe JP, Pinczewski LA. Endoscopic anterior cruciate ligament reconstruction in children using living donor hamstring tendon allografts. Am J Sports Med. 2013;41:567–74.

    Article  Google Scholar 

  4. Kim SJ, Shim DW, Park KW. Functional outcome of transphyseal reconstruction of the anterior cruciate ligament in skeletally immature patients. Knee Surg Relat Res. 2012;24:173–9.

    Article  Google Scholar 

  5. Kumar S, Ahearne D, Hunt DM. Transphyseal anterior cruciate ligament reconstruction in the skeletally immature: follow-up to a minimum of sixteen years of age. J Bone Joint Surg Am. 2013;95:e1.

    Article  Google Scholar 

  6. Moksnes H, Engebretsen L, Eitzen I, Risberg MA. Functional outcomes following a non-operative treatment algorithm for anterior cruciate ligament injuries in skeletally immature children 12 years and younger. A prospective cohort with 2 years follow-up. Br J Sports Med. 2013;47:488–94.

    Article  Google Scholar 

  7. Moksnes H, Engebretsen L. It takes more than timing: letter to the editor. Am J Sports Med. 2015;43:NP14–5.

    Article  Google Scholar 

  8. Reider B. A matter of timing. Am J Sports Med. 2015;43:273–4.

    Article  Google Scholar 

  9. Moksnes H, Engebretsen L, Risberg MA. The current evidence for treatment of acl injuries in children is low: a systematic review. J Bone Joint Surg Am. 2012;94:1112–9.

    Article  Google Scholar 

  10. Funahashi KM, Moksnes H, Maletis GB, Csintalan RP, Inacio MC, Funahashi TT. Anterior cruciate ligament injuries in adolescents with open physis: effect of recurrent injury and surgical delay on meniscal and cartilage injuries. Am J Sports Med. 2014;42:1068–73.

    Article  Google Scholar 

  11. Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W, Georgoulis T, Hewett TE, Johnson R, Krosshaug T, Mandelbaum B, Micheli L, Myklebust G, Roos E, Roos H, Schamasch P, Shultz S, Werner S, Wojtys E, Engebretsen L. Non-contact acl injuries in female athletes: an international olympic committee current concepts statement. Br J Sports Med. 2008;42:394–412.

    Article  CAS  Google Scholar 

  12. Moksnes H, Engebretsen L, Seil R. The esska paediatric anterior cruciate ligament monitoring initiative. Knee Surg Sports Traumatol Arthrosc. 2016;24:680–7.

    Article  Google Scholar 

  13. Aichroth PM, Patel DV, Zorrilla P. The natural history and treatment of rupture of the anterior cruciate ligament in children and adolescents. A prospective review. J Bone Joint Surg (Br). 2002;84:38–41.

    Article  CAS  Google Scholar 

  14. Cohen M, Ferretti M, Quarteiro M, Marcondes FB, de Hollanda JP, Amaro JT, Abdalla RJ. Transphyseal anterior cruciate ligament reconstruction in patients with open physes. Arthroscopy. 2009;25:831–8.

    Article  Google Scholar 

  15. Mizuta H, Kubota K, Shiraishi M, Otsuka Y, Nagamoto N, Takagi K. The conservative treatment of complete tears of the anterior cruciate ligament in skeletally immature patients. J Bone Joint Surg (Br). 1995;77:890–4.

    Article  CAS  Google Scholar 

  16. Anderson AF, Anderson CN. Correlation of meniscal and articular cartilage injuries in children and adolescents with timing of anterior cruciate ligament reconstruction. Am J Sports Med. 2015;43:275–81.

    Article  Google Scholar 

  17. Frosch KH, Stengel D, Brodhun T, Stietencron I, Holsten D, Jung C, Reister D, Voigt C, Niemeyer P, Maier M, Hertel P, Jagodzinski M, Lill H. Outcomes and risks of operative treatment of rupture of the anterior cruciate ligament in children and adolescents. Arthroscopy. 2010;26:1539–50.

    Article  Google Scholar 

  18. Kaeding CC, Flanigan D, Donaldson C. Surgical techniques and outcomes after anterior cruciate ligament reconstruction in preadolescent patients. Arthroscopy. 2010;26:1530–8.

    Article  Google Scholar 

  19. Werner BC, Yang S, Looney AM, Gwathmey FW Jr. Trends in pediatric and adolescent anterior cruciate ligament injury and reconstruction. J Pediatr Orthop. 2016;36:447–52.

    Article  Google Scholar 

  20. Dodwell ER, Lamont LE, Green DW, Pan TJ, Marx RG, Lyman S. 20 years of pediatric anterior cruciate ligament reconstruction in new york state. Am J Sports Med. 2014;42:675–80.

    Article  Google Scholar 

  21. Moksnes H, Engebretsen L, Risberg MA. Management of anterior cruciate ligament injuries in skeletally immature individuals. J Orthop Sports Phys Ther. 2012;42:172–83.

    Article  Google Scholar 

  22. Anderson CN, Anderson AF. Management of the anterior cruciate ligament-injured knee in the skeletally immature athlete. Clin Sports Med. 2017;36:35–52.

    Article  Google Scholar 

  23. Dumont GD, Hogue GD, Padalecki JR, Okoro N, Wilson PL. Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: relationship of treatment time and patient-specific factors. Am J Sports Med. 2012;40:2128–33.

    Article  Google Scholar 

  24. Ramski DE, Kanj WW, Franklin CC, Baldwin KD, Ganley TJ. Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med. 2014;42:2769–76.

    Article  Google Scholar 

  25. Vavken P, Tepolt FA, Kocher MS. Concurrent meniscal and chondral injuries in pediatric and adolescent patients undergoing acl reconstruction. J Pediatr Orthop. 2016. https://doi.org/10.1097/BPO.0000000000000777.

  26. Heckmann TP, Barber-Westin SD, Noyes FR. Meniscal repair and transplantation: indications, techniques, rehabilitation, and clinical outcome. J Orthop Sports Phys Ther. 2006;36:795–814.

    Article  Google Scholar 

  27. Kocher MS, Saxon HS, Hovis WD, Hawkins RJ. 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. 2002;22:452–7.

    PubMed  Google Scholar 

  28. Astur DC, Arliani GG, Debieux P, Kaleka CC, Amaro JT, Cohen M. Intraarticular hamstring graft diameter decreases with continuing knee growth after acl reconstruction with open physes. Knee Surg Sports Traumatol Arthrosc. 2016;24:792–5.

    Article  Google Scholar 

  29. Bollen S, Pease F, Ehrenraich A, Church S, Skinner J, Williams A. Changes in the four-strand hamstring graft in anterior cruciate ligament reconstruction in the skeletally-immature knee. J Bone Joint Surg (Br). 2008;90:455–9.

    Article  CAS  Google Scholar 

  30. Kocher MS, Garg S, Micheli LJ. Physeal sparing reconstruction of the anterior cruciate ligament in skeletally immature prepubescent children and adolescents. J Bone Joint Surg Am. 2005;87:2371–9.

    Article  Google Scholar 

  31. Kocher MS, Smith JT, Zoric BJ, Lee B, Micheli LJ. Transphyseal anterior cruciate ligament reconstruction in skeletally immature pubescent adolescents. J Bone Joint Surg Am. 2007;89:2632–9.

    Article  Google Scholar 

  32. Chotel F, Henry J, Seil R, Chouteau J, Moyen B, Berard J. Growth disturbances without growth arrest after acl reconstruction in children. Knee Surg Sports Traumatol Arthrosc. 2010;18:1496–500.

    Article  Google Scholar 

  33. Shifflett GD, Green DW, Widmann RF, Marx RG. Growth arrest following acl reconstruction with hamstring autograft in skeletally immature patients: a review of 4 cases. J Pediatr Orthop. 2016;36:355–61.

    Article  Google Scholar 

  34. Zimmerman LJ, Jauregui JJ, Riis JF, Tuten HR. Symmetric limb overgrowth following anterior cruciate ligament reconstruction in a skeletally immature patient. J Pediatr Orthop B. 2015;24:530–4.

    Article  Google Scholar 

  35. Kruse LM, Gray BL, Wright RW. Anterior cruciate ligament reconstruction rehabilitation in the pediatric population. Clin Sports Med. 2011;30:817–24.

    Article  Google Scholar 

  36. Mohtadi N, Grant J. Managing anterior cruciate ligament deficiency in the skeletally immature individual: a systematic review of the literature. Clin J Sport Med. 2006;16:457–64.

    Article  Google Scholar 

  37. Grindem H, Granan LP, Risberg MA, Engebretsen L, Snyder-Mackler L, Eitzen I. How does a combined preoperative and postoperative rehabilitation programme influence the outcome of acl reconstruction 2 years after surgery? A comparison between patients in the delaware-oslo acl cohort and the norwegian national knee ligament registry. Br J Sports Med. 2015;49:385–9.

    Article  CAS  Google Scholar 

  38. Lynch AD, Logerstedt DS, Grindem H, Eitzen I, Hicks GE, Axe MJ, Engebretsen L, Risberg MA, Snyder-Mackler L. Consensus criteria for defining ‘successful outcome’ after acl injury and reconstruction: a delaware-oslo acl cohort investigation. Br J Sports Med. 2015;49:335–42.

    Article  Google Scholar 

  39. Moksnes H, Engebretsen L, Risberg MA. 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. 2013;41:1771–9.

    Article  Google Scholar 

  40. Moksnes H, Engebretsen L, Risberg MA. 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. 2008;16:214–23.

    Article  Google Scholar 

  41. Woods GW, O'Connor DP. Delayed anterior cruciate ligament reconstruction in adolescents with open physes. Am J Sports Med. 2004;32:201–10.

    Article  Google Scholar 

  42. Moksnes H, Grindem H. Prevention and rehabilitation of paediatric anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc. 2016;24:730–6.

    Article  Google Scholar 

  43. Faber M, Andersen MH, Sevel C, Thorborg K, Bandholm T, Rathleff M. The majority are not performing home-exercises correctly two weeks after their initial instruction-an assessor-blinded study. Peer J. 2015;3:e1102.

    Article  Google Scholar 

  44. Faigenbaum AD, Kraemer WJ, Blimkie CJ, Jeffreys I, Micheli LJ, Nitka M, Rowland TW. Youth resistance training: updated position statement paper from the national strength and conditioning association. J Strength Cond Res. 2009;23:S60–79.

    Article  Google Scholar 

  45. Hewett TE, Ford KR, Myer GD. Anterior cruciate ligament injuries in female athletes: part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med. 2006;34:490–8.

    Article  Google Scholar 

  46. McKay CD, Steffen K, Romiti M, Finch CF, Emery CA. The effect of coach and player injury knowledge, attitudes and beliefs on adherence to the fifa 11+ programme in female youth soccer. Br J Sports Med. 2014;48:1281–6.

    Article  Google Scholar 

  47. Steffen K, Emery CA, Romiti M, Kang J, Bizzini M, Dvorak J, Finch CF, Meeuwisse WH. High adherence to a neuromuscular injury prevention programme (fifa 11+) improves functional balance and reduces injury risk in canadian youth female football players: a cluster randomised trial. Br J Sports Med. 2013;47:794–802.

    Article  Google Scholar 

  48. Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, Lazaro-Haro C, Cugat R. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: mechanisms of injury and underlying risk factors. Knee Surg Sports Traumatol Arthrosc. 2009;17:705–29.

    Article  Google Scholar 

  49. Olsen OE, Myklebust G, Engebretsen L, Holme I, Bahr R. Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial. BMJ. 2005;330:449.

    Article  Google Scholar 

  50. Soligard T, Myklebust G, Steffen K, Holme I, Silvers H, Bizzini M, Junge A, Dvorak J, Bahr R, Andersen TE. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ. 2008;337:a2469.

    Article  Google Scholar 

  51. Millett PJ, Willis AA, Warren RF. Associated injuries in pediatric and adolescent anterior cruciate ligament tears: does a delay in treatment increase the risk of meniscal tear? Arthroscopy. 2002;18:955–9.

    Article  Google Scholar 

  52. Streich NA, Barie A, Gotterbarm T, Keil M, Schmitt H. Transphyseal reconstruction of the anterior cruciate ligament in prepubescent athletes. Knee Surg Sports Traumatol Arthrosc. 2010;18:1481–6.

    Article  Google Scholar 

  53. Henry J, Chotel F, Chouteau J, Fessy MH, Berard J, Moyen B. Rupture of the anterior cruciate ligament in children: early reconstruction with open physes or delayed reconstruction to skeletal maturity? Knee Surg Sports Traumatol Arthrosc. 2009;17:748–55.

    Article  Google Scholar 

  54. McCarthy MM, Graziano J, Green DW, Cordasco FA. All-epiphyseal, all-inside anterior cruciate ligament reconstruction technique for skeletally immature patients. Arthrosc Tech. 2012;1:e231–9.

    Article  Google Scholar 

  55. Fabricant PD, Jones KJ, Delos D, Cordasco FA, Marx RG, Pearle AD, Warren RF, Green DW. Reconstruction of the anterior cruciate ligament in the skeletally immature athlete: a review of current concepts: aaos exhibit selection. J Bone Joint Surg Am. 2013;95:e28.

    Article  Google Scholar 

  56. Chotel F, Seil R. Growth disturbances after transphyseal acl reconstruction in skeletally immature patients: who is more at risk? Young child or adolescent? J Pediatr Orthop. 2013;33:585–6.

    Article  Google Scholar 

  57. Lemaitre G, Salle de Chou E, Pineau V, Rochcongar G, Delforge S, Bronfen C, Haumont T, Hulet C. Acl reconstruction in children: a transphyseal technique. Orthop Traumatol Surg Res. 2014;100:S261–5.

    Article  CAS  Google Scholar 

  58. Seil R, Weitz FK, Pape D. Surgical-experimental principles of anterior cruciate ligament (acl) reconstruction with open growth plates. J Exp Orthop. 2015;2:11.

    Article  Google Scholar 

  59. Chotel F, Bonnard C, Accabled F, Gicquel P, Bergerault F, Robert H, Seil R, Hulet C, Cassard X, Garraud P. Résultats et facteurs pronostiques de la reconstruction de lca sur genou en croissance. A propos d'une série multicentrique de 102 cas. Rev Chir Orthop Reparatrice Apar Mot. 2007;93:3s131–8.

    Google Scholar 

  60. Shea KG, Apel PJ, Pfeiffer RP. Anterior cruciate ligament injury in paediatric and adolescent patients: a review of basic science and clinical research. Sports Med. 2003;33:455–71.

    Article  Google Scholar 

  61. Seil R, Pape D, Kohn D. The risk of growth changes during transphyseal drilling in sheep with open physes. Arthroscopy. 2008;24:824–33.

    Article  Google Scholar 

  62. Stadelmaier DM, Arnoczky SP, Dodds J, Ross H. The effect of drilling and soft tissue grafting across open growth plates. A histologic study. Am J Sports Med. 1995;23:431–5.

    Article  CAS  Google Scholar 

  63. Koman JD, Sanders JO. Valgus deformity after reconstruction of the anterior cruciate ligament in a skeletally immature patient. A case report. J Bone Joint Surg Am. 1999;81:711–5.

    Article  CAS  Google Scholar 

  64. McConkey MO, Bonasia DE, Amendola A. Pediatric anterior cruciate ligament reconstruction. Curr Rev. Musculoskelet Med. 2011;4:37–44.

    Article  Google Scholar 

  65. Robert HE, Casin C. Valgus and flexion deformity after reconstruction of the anterior cruciate ligament in a skeletally immature patient. Knee Surg Sports Traumatol Arthrosc. 2010;18:1369–73.

    Article  Google Scholar 

  66. Dorizas JA, Stanitski CL. Anterior cruciate ligament injury in the skeletally immature. Orthop Clin North Am. 2003;34:355–63.

    Article  Google Scholar 

  67. Lind M, Menhert F, Pedersen AB. The first results from the danish acl reconstruction registry: epidemiologic and 2 year follow-up results from 5,818 knee ligament reconstructions. Knee Surg Sports Traumatol Arthrosc. 2009;17:117–24.

    Article  Google Scholar 

  68. Fauno P, Romer L, Nielsen T, Lind M. The risk of transphyseal drilling in skeletally immature patients with anterior cruciate ligament injury. Orthop J Sports Med. 2016;4:2325967116664685.

    PubMed  PubMed Central  Google Scholar 

  69. Kohl S, Stutz C, Decker S, Ziebarth K, Slongo T, Ahmad SS, Kohlhof H, Eggli S, Zumstein M, Evangelopoulos DS. Mid-term results of transphyseal anterior cruciate ligament reconstruction in children and adolescents. Knee. 2014;21:80–5.

    Article  Google Scholar 

  70. Schmale GA, Kweon C, Larson RV, Bompadre V. High satisfaction yet decreased activity 4 years after transphyseal acl reconstruction. Clin Orthop Relat Res. 2014;472:2168–74.

    Article  Google Scholar 

  71. Koizumi H, Kimura M, Kamimura T, Hagiwara K, Takagishi K. The outcomes after anterior cruciate ligament reconstruction in adolescents with open physes. Knee Surg Sports Traumatol Arthrosc. 2013;21:950–6.

    Article  Google Scholar 

  72. Willimon SC, Jones CR, Herzog MM, May KH, Leake MJ, Busch MT. Micheli anterior cruciate ligament reconstruction in skeletally immature youths: a retrospective case series with a mean 3-year follow-up. Am J Sports Med. 2015;43:2974–81.

    Article  Google Scholar 

  73. Ho B, Edmonds EW, Chambers HG, Bastrom TP, Pennock AT. Risk factors for early acl reconstruction failure in pediatric and adolescent patients: a review of 561 cases. J Pediatr Orthop. 2016. https://doi.org/10.1097/BPO.0000000000000831.

  74. Fauno P, Rahr-Wagner L, Lind M. Risk for revision after anterior cruciate ligament reconstruction is higher among adolescents: results from the danish registry of knee ligament reconstruction. Orthop J Sports Med. 2014;2:2325967114552405.

    PubMed  PubMed Central  Google Scholar 

  75. Andernord D, Desai N, Bjornsson H, Ylander M, Karlsson J, Samuelsson K. Patient predictors of early revision surgery after anterior cruciate ligament reconstruction: a cohort study of 16,930 patients with 2-year follow-up. Am J Sports Med. 2015;43:121–7.

    Article  Google Scholar 

  76. Pierce TP, Issa K, Festa A, Scillia AJ, McInerney VK. Pediatric anterior cruciate ligament reconstruction. Am J Sports Med. 2017;45:488–94.

    Article  Google Scholar 

  77. Vavken P, Murray MM. Treating anterior cruciate ligament tears in skeletally immature patients. Arthroscopy. 2011;27:704–16.

    Article  Google Scholar 

  78. Newman JT, Carry PM, Terhune EB, Spruiell MD, Heare A, Mayo M, Vidal AF. Factors predictive of concomitant injuries among children and adolescents undergoing anterior cruciate ligament surgery. Am J Sports Med. 2015;43:282–8.

    Article  Google Scholar 

  79. Mansson O, Sernert N, Rostgard-Christensen L, Kartus J. Long-term clinical and radiographic results after delayed anterior cruciate ligament reconstruction in adolescents. Am J Sports Med. 2015;43:138–45.

    Article  Google Scholar 

  80. de Vet HC, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine. Cambridge: Cambridge University Press; 2011.

    Book  Google Scholar 

  81. Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;346:f167.

    Article  Google Scholar 

  82. Kocher MS, Smith JT, Iversen MD, Brustowicz K, Ogunwole O, Andersen J, Yoo WJ, McFeely ED, Anderson AF, Zurakowski D. Reliability, validity, and responsiveness of a modified international knee documentation committee subjective knee form (pedi-ikdc) in children with knee disorders. Am J Sports Med. 2011;39:933–9.

    Article  Google Scholar 

  83. Ortqvist M, Iversen MD, Janarv PM, Brostrom EW, Roos EM. Psychometric properties of the knee injury and osteoarthritis outcome score for children (koos-child) in children with knee disorders. Br J Sports Med. 2014;48:1437–46.

    Article  Google Scholar 

  84. Schmitt LC, Paterno MV, Huang S. Validity and internal consistency of the international knee documentation committee subjective knee evaluation form in children and adolescents. Am J Sports Med. 2010;38:2443–7.

    Article  Google Scholar 

  85. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42.

    Article  Google Scholar 

  86. Iversen MD, Lee B, Connell P, Andersen J, Anderson AF, Kocher MS. Validity and comprehensibility of the international knee documentation committee subjective knee evaluation form in children. Scand J Med Sci Sports. 2010;20:e87–95.

    Article  CAS  Google Scholar 

  87. Oak SR, O'Rourke C, Strnad G, Andrish JT, Parker RD, Saluan P, Jones MH, Stegmeier NA, Spindler KP. Statistical comparison of the pediatric versus adult ikdc subjective knee evaluation form in adolescents. Am J Sports Med. 2015;43:2216–21.

    Article  Google Scholar 

  88. Ortqvist M, Roos EM, Brostrom EW, Janarv PM, Iversen MD. Development of the knee injury and osteoarthritis outcome score for children (koos-child): comprehensibility and content validity. Acta Orthop. 2012;83:666–73.

    Article  Google Scholar 

  89. Shirazi CP, Israel HA, Kaar SG. Is the marx activity scale reliable in patients younger than 18 years? Sports Health. 2016;8:145–8.

    Article  Google Scholar 

  90. Jacobsen JS, Knudsen P, Fynbo C, Rolving N, Warming S. Reproducibility and responsiveness of a danish pedi-ikdc subjective knee form for children with knee disorders. Scand J Med Sci Sports. 2016;26:1408–14.

    Article  CAS  Google Scholar 

  91. Boykin RE, McFeely ED, Shearer D, Frank JS, Harrod CC, Nasreddine AY, Kocher MS. Correlation between the child health questionnaire and the international knee documentation committee score in pediatric and adolescent patients with an anterior cruciate ligament tear. J Pediatr Orthop. 2013;33:216–20.

    Article  Google Scholar 

  92. Nasreddine AY, Connell PL, Kalish LA, Nelson S, Iversen MD, Anderson AF, Kocher MS. The pediatric international knee documentation committee (pedi-ikdc) subjective knee evaluation form: normative data. Am J Sports Med. 2016;45(3):527–34. https://doi.org/10.1177/0363546516672456.

    Article  PubMed  Google Scholar 

  93. Van der Velden CA, Van der Steen MC, Leenders J, van Douveren FQ, Janssen RP, Reijman M. Pedi-ikdc or koos-child: which questionnaire should be used in Dutch children with knee disorders? A translation, cross-cultural adaptation, validation and reliability study. Br J Sports Med. 2017. In Review.

    Google Scholar 

  94. Dietvorst M, Reijman M, van Groningen B, van der Steen M, Janssen RP. PROMs in pediatric knee ligament injury: use the Pedi-IKDC and avoid using adult PROMs. Knee Surg Sports Traumatol Arthrosc. 2017;16:2017. https://doi.org/10.1007/s00167-017-4687-3.

    Article  Google Scholar 

  95. Fabricant PD, Robles A, McLaren SH, Marx RG, Widmann RF, Green DW. Hospital for special surgery pediatric functional activity brief scale predicts physical fitness testing performance. Clin Orthop Relat Res. 2014;472:1610–6.

    Article  Google Scholar 

  96. Fabricant PD, Robles A, Downey-Zayas T, Do HT, Marx RG, Widmann RF, Green DW. Development and validation of a pediatric sports activity rating scale: the hospital for special surgery pediatric functional activity brief scale (hss pedi-fabs). Am J Sports Med. 2013;41:2421–9.

    Article  Google Scholar 

  97. Marx RG. Knee rating scales. Arthroscopy. 2003;19:1103–8.

    Article  Google Scholar 

  98. Murray MM, Fleming BC. Use of a bioactive scaffold to stimulate anterior cruciate ligament healing also minimizes posttraumatic osteoarthritis after surgery. Am J Sports Med. 2013;41:1762–70.

    Article  Google Scholar 

  99. Murray MM, Martin SD, Martin TL, Spector M. Histological changes in the human anterior cruciate ligament after rupture. J Bone Joint Surg Am. 2000;82-A:1387–97.

    Article  CAS  Google Scholar 

  100. Frank C, Woo SL, Amiel D, Harwood F, Gomez M, Akeson W. Medial collateral ligament healing. A multidisciplinary assessment in rabbits. Am J Sports Med. 1983;11:379–89.

    Article  CAS  Google Scholar 

  101. Harrold AJ. The defect of blood coagulation in joints. J Clin Pathol. 1961;14:305–8.

    Article  CAS  Google Scholar 

  102. Murray MM, Magarian E, Zurakowski D, Fleming BC. Bone-to-bone fixation enhances functional healing of the porcine anterior cruciate ligament using a collagen-platelet composite. Arthroscopy. 2010;26:S49–57.

    Article  Google Scholar 

  103. Murray MM, Flutie BM, Kalish LA, Ecklund K, Fleming BC, Proffen BL, Micheli LJ. The bridge-enhanced anterior cruciate ligament repair (bear) procedure: an early feasibility cohort study. Orthop J Sports Med. 2016;4:2325967116672176.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rob Janssen .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 ESSKA

About this chapter

Cite this chapter

Janssen, R. et al. (2018). Pediatric ACL Injuries: Treatment and Challenges. In: Kerkhoffs, G.M.M.J., Haddad, F., Hirschmann, M.T., Karlsson, J., Seil, R. (eds) ESSKA Instructional Course Lecture Book. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56127-0_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-56127-0_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56126-3

  • Online ISBN: 978-3-662-56127-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics