Watch Dr. Peter Gambacorta discuss a story about one of his pediatric ACL patients on Channel 2 News:
Pediatric ACL Injuries
Over the past twenty years, sports injuries in the pediatric and adolescent athlete have dramatically increased. Approximately 30,000,000 young athletes participate in organized sports annually in the United States. Of those nearly two million high school students and almost twice as many athletes under the age of 14 sustain a sports-related injury each year. This new epidemic of sports-related injuries can be partially attributed to the dramatic surge in the number of participants since the creation of title IX combined with increased emphasis on year-round competition, single sport concentration and more intense training.
Injuries to the anterior cruciate ligament (ACL) were once thought to be a rare phenomenon in a pediatric athlete. Mid-substance tears were believed to occur only in adults as the tibial eminence fracture was considered the pediatric equivalent of the ACL tear. The incidence of mid-substance tears in this age group has grown considerably, especially with sports that include cutting, pivoting and collision.
Management of ACL injuries in the skeletally immature athlete is challenging. The traditional arthroscopically assisted osseous tunnel placement for ACL reconstruction is highly effective in preventing instability in adults. This technique is usually avoided in younger patients with significant growth remaining because drilling across the growth plate carries a potential risk of growth disturbance and angular deformity. The historical approach to a young patient with an ACL tear would consist of activity modification and bracing until the onset of skeletally maturity at which point a traditional transphyseal ACL reconstruction could safely be performed. Unfortunately, conservative treatment commonly leads to recurrent instability, resulting in secondary injuries to the surrounding articular cartilage and menisci. Several physeal sparing ACL reconstruction techniques have been developed to stabilize the knee and minimize the risk of physeal disruption.
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This information is intended for education of the reader about medical conditions and current treatments. It is not a substitute for examination, diagnosis, and care provided by your physician or a licensed healthcare provider. If you believe that you, your child, or someone you know has the condition described herein, please see your healthcare provider. Do not attempt to treat yourself or anyone else without proper medical attention.