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Updated: Mar 14, 2026
Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Pediatric anterior cruciate ligament reconstruction outcomes
Devin C Peterson1, Olufemi R Ayeni2
1Department of Surgery, McMaster University, 1200 Main Street West, Suite 4E11, Hamilton, ON, Canada. dpeters@mcmaster.ca.
Insights
Pediatric anterior cruciate ligament (ACL) reconstruction is controversial. Early surgery may prevent further joint damage, but carries risks; patient education is crucial for optimal outcomes in skeletally immature patients.
Area of Science:
- Orthopedic surgery
- Pediatric sports medicine
- Skeletal immaturity
Background:
- Anterior cruciate ligament (ACL) injuries in skeletally immature patients present unique management challenges.
- Delayed surgical treatment can lead to secondary meniscal and chondral damage, negatively impacting outcomes.
- Existing surgical techniques have variable success rates and potential for growth disturbances.
Approach:
- Review of current literature on pediatric ACL reconstruction techniques.
- Analysis of factors contributing to treatment controversies and unfavorable outcomes.
- Identification of key principles for managing ACL injuries in young athletes.
Key Points:
- Skeletally immature patients with ACL injuries require specialized treatment considerations.
- The risk of secondary injuries increases with delayed surgical intervention.
- Patient and caregiver education is paramount due to potential complications like growth disturbances and high failure rates (15-25%).
Conclusions:
- Optimizing treatment for pediatric ACL injuries necessitates careful consideration of skeletal maturity.
- Adherence to key surgical principles can mitigate risks and improve outcomes.
- Further research with robust methodologies is needed to refine treatment strategies for this population.
Abstract:
Treatment of pediatric anterior cruciate injuries have become an area of controversy sparking much debate about best management strategies. Delaying surgery until skeletal maturity has often been shown to result in unfavorable outcomes due to concomitant meniscal and chondral injuries in this population. There have been numerous techniques used to reconstruct the ACL in the skeletally immature patient; however, most studies are limited by small patient numbers and other methodological concerns. With recent publications reporting failure rates as high as 15-25 % and growth disturbances being uncommon but now reported within almost every technical category, patient and caregiver education become of paramount importance. Key principles will be outlined that may help to avoid some of the pitfalls that occur when dealing with this unique population.
