Anterior Cruciate Ligament Injuries in Young Athletes

摘要

In the past, tibial eminence fractures were considered the pediatric equivalent of adult anterior cruciate ligament (ACL) tears, and ACL tears in the skeletally immature patient were thought to be rare. Recently, however, this idea has been challenged by newer studies reporting a higher incidence of ACL tears in young athletes. Up to 47% of patients aged 7 to 12 years and 65% of patients aged 13 to 18 years who present with an acute traumatic knee hemarthrosis are found to have an ACL tear at time of arthroscopy.1 Several factors are implicated in the increased incidence of ACL tears in the pediatric population. First, there has been an increase in overall youth participation in cutting-and-pivoting sports, including soccer, football, hockey, and skiing. Second, these athletes are playing at higher intensity at younger ages. Increased participation and intensity in cutting-and-pivoting and contact sports, combined with increased physician awareness and diagnostic methods, are responsible for the increased incidence in pediatric ACL injuries. Last, treatment of ACL injuries in skeletally immature patients remains controversial. In this article, we outline 5 points on diagnosis and treatment of ACL injuries in young athletes.