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
. 2023 Feb;17(1):4-11.
doi: 10.1177/18632521231153277. Epub 2023 Jan 30.

Pediatric anterior cruciate ligament tears and associated lesions: Epidemiology, diagnostic process, and imaging

Julio Duart  1 , Luca Rigamonti  2   3   4 , Marco Bigoni  2   3   4 , Mininder S Kocher  5   6
Affiliations
Review

Pediatric anterior cruciate ligament tears and associated lesions: Epidemiology, diagnostic process, and imaging

Julio Duart et al. J Child Orthop. 2023 Feb.

Abstract

The incidence of anterior cruciate ligament injuries in skeletally immature patients has increased in recent years. The gold standard treatment of this type of trauma in children is not yet established. Conservative management may underestimate the risk of new meniscal and chondral tears; on the other hand, a more interventional approach may expose the patient to iatrogenic damage to the growth plate. A correct approach to the skeletally immature patient with knee trauma is therefore essential to guide the decision-making process. This review article aims to present an update on the epidemiology and diagnostic process of pediatric patients with anterior cruciate ligament tears and possible associated injuries. Level of Evidence: V.

Keywords: ACL; Anterior cruciate ligament; pediatric; skeletally immature.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Gender-related incidence of ACL injury.
Figure 2.
Figure 2.
ACL incidence rate in relation to gender and sports.
Figure 3.
Figure 3.
(a) Radiographic lateral view of knee after trauma with a spinal avulsion. (b) Radiographic anteroposterior view of an osteochondral lesion of the medial femoral condyle.
Figure 4.
Figure 4.
MRI of the knee. (a) Normal ACL images. (b) ACL tear.
Figure 5.
Figure 5.
Primary findings that suggest an ACL injury are abnormal signal intensity of the ACL (a), discontinuity of the ligament (b), a Blumensaat’s angle > 9.5° (c).
Figure 6.
Figure 6.
Secondary criteria for ACL injury diagnose include lateral compartment bone bruise (a), anterior tibial displacement (b), uncovered posterior horn of the lateral meniscus (c), change in the posterior cruciate line, and posterior cruciate angle < 115° (d).
See this image and copyright information in PMC

References

    1. Parikh SN, Jaquith BP, Brusalis CM, et al.. Skeletally immature anterior cruciate ligament injuries: controversies and management. Instr Course Lect 2017; 66: 461–474. - PubMed
    1. Louw QA, Manilall J, Grimmer KA. Epidemiology of knee injuries among adolescents: a systematic review. Br J Sports Med 2008; 42(1): 2–10. - PubMed
    1. Shea KG, Grimm NL, Ewing CK, et al.. Youth sports anterior cruciate ligament and knee injury epidemiology: who is getting injured? In what sports? When? Clin Sports Med 2011; 30(4): 691–706. - PubMed
    1. Bigoni M, Turati M, Zatti G, et al.. Intra-articular cytokine levels in adolescent patients after anterior cruciate ligament tear. Mediators Inflamm 2018; 2018: 4210593. - PMC - PubMed
    1. Koman JD, Sanders JO. Valgus deformity after reconstruction of the anterior cruciate ligament in a skeletally immature patient. A case report. J Bone Joint Surg Am 1999; 81: 711–715. - PubMed

LinkOut - more resources