Pediatric ACL in Sports, Prognosis, Decision Making and Outcomes of Management
Journal Title: Journal of Clinical Orthopaedics - Year 2018, Vol 0, Issue 0
Abstract
Anterior cruciate ligament (ACL) injuries in pediatric & adolescent patients may occur as tibial eminence fractures, mid-substance ligament injuries and peel-off injuries of the femoral insertion site. ACL injuries in adolescents nearing skeletal maturity may be treated as adults without risk of deformity or leg length discrepancy. Treatment of ACL injuries children with wide open physes and substantial remaining growth are controversial. Disappointing functional results and an increased prevalence of secondary meniscal and cartilage damage with conservative management have led to an increased utilization of surgical treatment in these children. ACL reconstruction with soft tissue grafts and physeal sparing techniques are considered the gold standard of surgical management. Primary repair combined with healing enhancement techniques for femoral peel-off injuries with minimal damage to the body of the ACL can be used in select cases. The rates of growth disturbance after ACL surgery remain low with modern techniques and are usually clinically insignificant. However, a higher rate of failure and need for revision has been reported in pediatric & adolescent ACL injuries compared to adults. The risk of failure increases in patients with allografts and who return to high risk impact sports.
Authors and Affiliations
Reha N. Tandoğan, Metin Polat
Keywords
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