Management of ACL Injuries in Children and Adolescents
Anterior cruciate ligament (ACL) tears, which were once considered rare in skeletally immature athletes, are now observed with increasing frequency1-3. A dramatic rise in competitive athletic activity among children and adolescents, early sport specialization, increased awareness of these injuries in children, and year-round training and competition may contribute to a commensurate increase in the frequency of diagnosis of pediatric ACL tears. Epidemiological analysis has indicated that the rate of ACL reconstruction in children under the age of 20 years increased nearly threefold between 1990 and 2009 in the United States, and that adolescents and teenagers represent the largest per capita demographic of patients having ACL reconstructions1. Furthermore, ambulatory ACL procedures in patients <15 years old increased 924% from 1994 to 20062,3.