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Pediatric anterior cruciate ligament tears and associated lesions: Epidemiology, diagnostic process, and imaging
Julio Duart1, Luca Rigamonti2,3,4, Marco Bigoni2,3,4
1Department of Orthopedic Surgery, Hospital Universitario de Navarra, Pamplona, Spain.
Insights
Pediatric anterior cruciate ligament (ACL) injuries are rising, with no established treatment. This review updates on epidemiology, diagnosis, and associated injuries in children, crucial for guiding treatment decisions.
Area of Science:
- Orthopedic Surgery
- Pediatric Sports Medicine
- Knee Injuries
Background:
- Increasing incidence of anterior cruciate ligament (ACL) injuries in skeletally immature patients.
- Lack of established gold standard treatment for pediatric ACL tears.
- Treatment challenges include risks of under-treatment (meniscal/chondral tears) versus over-treatment (growth plate damage).
Purpose of the Study:
- To provide an updated review on the epidemiology of pediatric anterior cruciate ligament (ACL) tears.
- To outline the diagnostic process for these injuries in children.
- To discuss associated injuries and guide clinical decision-making.
Main Methods:
- Literature review focusing on pediatric anterior cruciate ligament (ACL) injuries.
- Synthesis of current evidence on epidemiology and diagnosis.
- Analysis of treatment considerations and associated injuries.
Main Results:
- The incidence of pediatric ACL tears is increasing.
- Diagnostic challenges exist due to the unique anatomy of skeletally immature patients.
- Associated meniscal and chondral injuries are common and impact treatment.
Conclusions:
- A clear understanding of pediatric ACL injury epidemiology and diagnosis is essential.
- Careful consideration of growth plate status is critical in treatment planning.
- Further research is needed to establish optimal treatment guidelines for this population.
Abstract:
The incidence of anterior cruciate ligament injuries in skeletally immature patients has increased in recent years. The gold standard treatment of this type of trauma in children is not yet established. Conservative management may underestimate the risk of new meniscal and chondral tears; on the other hand, a more interventional approach may expose the patient to iatrogenic damage to the growth plate. A correct approach to the skeletally immature patient with knee trauma is therefore essential to guide the decision-making process. This review article aims to present an update on the epidemiology and diagnostic process of pediatric patients with anterior cruciate ligament tears and possible associated injuries. Level of Evidence: V.
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