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Anterior Cruciate Ligament (ACL) injuries in pediatric patients are rising and present unique challenges for orthopedic surgeons due to skeletal immaturity and risk for physeal damage during ACL reconstruction. This review aims to share insights from pediatric cadaveric anatomic studies and related research to inform surgical management of ACL injuries in skeletally immature patients. We highlight age-dependent variations in the distances between the ACL and medial collateral ligament and their respective physes, developmental variability in the anterolateral structures of the pediatric knee, and variability in the proximity of the neurovascular bundle's proximity to the iliotibial band graft pathway during ACL reconstruction. In addition, we review biomechanical properties of different grafts to assess their strength and suitability for ACL reconstruction. Our findings emphasize the importance of age-specific surgical approaches that consider individual anatomic differences of pediatric patients, collectively advancing our understanding of pediatric knee anatomy and its relevance to successful ACL reconstruction.
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http://dx.doi.org/10.1097/JSA.0000000000000418 | DOI Listing |
Clin J Sport Med
September 2025
Western University, London, Ontario, Canada.
Objective: Anterior cruciate ligament reconstruction (ACLR) leads to high rates of knee post-traumatic osteoarthritis (PTOA). Physical activity may mitigate PTOA risk but levels after ACLR have not been extensively studied. We aimed to review self-reported and device-measured physical activity levels in individuals with ACLR and compare them with international guidelines, and with uninjured controls.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2025
Department of Sports Medicine, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, China.
Knee Surg Sports Traumatol Arthrosc
September 2025
Department of Sport Orthopaedics, TUM University Clinic, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
Purpose: The purpose of this prospective study was to investigate the effect of Kaplan fibres (KF), anterolateral ligament (ALL) and lateral meniscus (LM) injuries on preoperative anterolateral rotational instability (ALRI) in anterior cruciate ligament (ACL)-injured knees. It was hypothesised that injuries to the ALC (i.e.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2025
Clinique du sport, Paris, France.
Purpose: To compare the outcomes of isolated anterior cruciate ligament reconstruction (ACLR) versus ACLR + lateral extra-articular procedures (LEAPs) at mid-term follow-up in a low activity population based on the Tegner activity scale (TAS ≤ 4).
Methods: This was a retrospective analysis comparing patients with a pre-injury TAS ≤ 4 who underwent primary isolated ACLR versus ACLR + LEAPs between 2012 and 2022. Propensity score matching based on age, sex, and presence of meniscal injury was used to establish two groups: ACLR alone and ACLR with LEAP.
Knee Surg Sports Traumatol Arthrosc
September 2025
Department of Orthopaedics and Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Purpose: Modifying interference screw composition may ensure better osteoconductive properties in order to reduce tunnel enlargement after anterior cruciate ligament (ACL) reconstruction. The primary and secondary purposes were to evaluate tunnel and screw volume changes in poly-L-lactide acid (PLLA) and poly-D-lactic acid + hydroxyapatite + β-tricalcium phosphate (PLDLA+) screws. The tertiary purpose was to compare patient reported- and functional outcomes between PLLA and PLDLA+ group.
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