Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jan 14;9(1):9.
doi: 10.1186/s40634-022-00448-0.

Limited evidence for graft selection in pediatric ACL reconstruction: a narrative review

Gianni De Petrillo  1 , Thierry Pauyo  1   2 , Corinna C Franklin  3 , Ross S Chafetz  3 , Marie-Lyne Nault  4   5 , Louis-Nicolas Veilleux  6   7
Affiliations
Review

Limited evidence for graft selection in pediatric ACL reconstruction: a narrative review

Gianni De Petrillo et al. J Exp Orthop. .

Abstract

Anterior cruciate ligament reconstruction is the preferred treatment to anterior cruciate ligament injury. With the increase in anterior cruciate ligament injuries in both adults and skeletally immature patients comes the need for individualized anterior cruciate ligament reconstruction graft selection whether it is the type of graft (auto vs. allograft) or the harvesting site (hamstrings, iliotibial band, quadriceps, patella). Several factors need to be considered preoperatively in order to optimize the patients' recovery and restore anterior cruciate ligament strength and function. These include age and bone maturity, preoperative knee flexor/extensor strength, sport participation, patient's needs and anatomical characteristics. This paper aims at bringing evidence supporting the use of a personalized approach in graft selection for faster and more efficient return to sport and propose a theoretical framework to support the approach.

Keywords: ACL reconstruction; Graft selection; Individualized; Pediatric; Recovery; Return to sport; Tear.

PubMed Disclaimer

Conflict of interest statement

The authors state that they have the following disclosures:

GDP: None

TP: Smith, Nephew: Consultant

CCF: None

RSC: None

MLN: Institutional grant for education

LNV: None

Figures

Fig. 1
Fig. 1
Simplified graft selection flowchart for ACLR in pediatric/adolescent patients. Pediatric and adolescent patients admitted for ACLR receive autografts best suited for their anatomical and personal needs. Physes status is first evaluated, followed by patient age. HT diameter, sex, sport participation and risk of anterior knee pain and surgical technique then guide final graft selection
See this image and copyright information in PMC

References

    1. Dodwell ER, Lamont LE, Green DW, Pan TJ, Marx RG, Lyman S. 20 years of pediatric anterior cruciate ligament reconstruction in New York State. Am J Sports Med. 2014;42:675–680. - PubMed
    1. Gornitzky AL, Lott A, Yellin JL, Fabricant PD, Lawrence JT, Ganley TJ. Sport-Specific Yearly Risk and Incidence of Anterior Cruciate Ligament Tears in High School Athletes: A Systematic Review and Meta-analysis. Am J Sports Med. 2016;44:2716–2723. - PubMed
    1. Jayanthi NA, LaBella CR, Fischer D, Pasulka J, Dugas LR. Sports-specialized intensive training and the risk of injury in young athletes: a clinical case-control study. Am J Sports Med. 2015;43:794–801. - PubMed
    1. Gopinathan P. Fate of the untreated anterior cruciate ligament-injured knee. J Orthop. 2017;14:A1–A3. - PMC - PubMed
    1. Spindler KP, Kuhn JE, Freedman KB, Matthews CE, Dittus RS, Harrell FE., Jr Anterior cruciate ligament reconstruction autograft choice: bone-tendon-bone versus hamstring: does it really matter? a systematic review. Am J Sports Med. 2004;32:1986–1995. - PubMed

LinkOut - more resources