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Pediatric Anterior Cruciate Ligament Tears: Epidemiology, Evaluation, and Evolving Treatment Strategies

Review Article | Volume 11 | Issue 2 | May-August 2025 | Page: 2-10 | Doria L. Weiss, Alexis Carr, Kevin Berardino, Kevin Quindlen, Rachel Talley-Bruns

DOI- https://doi.org/10.13107/ijpo.2025.v11.i02.226

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted: 01/06/2025; Reviewed: 30/06/2025; Accepted: 06/07/2025; Published: 10/08/2025

Authors: Doria L. Weiss BS [1] , Alexis Carr BS [1], Kevin Berardino MD [1], Kevin Quindlen MD [1], Rachel Talley-Bruns MD [1]

[1] Westchester Medical Center, Department of Orthopaedic Surgery, Valhalla, NY

Address of Correspondence

Dr. Doria L. Weiss,
Westchester Medical Center, Department of Orthopaedic Surgery, Valhalla, NY.
E-mail: dweiss23@student.nymc.edu

Abstract

Introduction: Anterior cruciate ligament (ACL) tears in pediatric patients are increasingly recognized due to rising sports participation and improved imaging. Given the presence of open physes, treatment decisions must balance the need for knee stability with the risk of growth disturbance. This review outlines current approaches to diagnosis, surgical techniques, graft selection, postoperative rehabilitation, and complications in skeletally immature patients.
Methods: This review summarizes recent literature on pediatric ACL injuries, including epidemiology, injury patterns, surgical management strategies, graft options, rehabilitation protocols, and complication rates. Emphasis is placed on the rationale behind technique selection based on skeletal maturity and long-term outcomes.
Results: Surgical reconstruction has become the preferred treatment for most pediatric ACL injuries to prevent secondary damage and restore knee stability. Several physeal-sparing and transphyseal techniques are available, with selection guided by skeletal age and growth remaining. All-epiphyseal and extraphyseal techniques avoid crossing the physis, while transphyseal reconstruction is safe in adolescents nearing skeletal maturity. Hamstring and quadriceps tendon autografts are most commonly used, while bone–patellar tendon–bone grafts and allografts are generally avoided in younger patients. Graft failure and growth disturbance remain key concerns, with retear rates reaching up to 20% and growth abnormalities occurring in 1–5% of cases. Rehabilitation protocols are evolving toward milestone-based progression, with return to sport typically delayed at least 12 months. However, re-injury rates remain high in this population.
Conclusions: ACL injuries in pediatric patients require a nuanced, age-specific approach. Surgical reconstruction using physeal-respecting or transphyseal techniques offers favorable outcomes when matched to skeletal maturity. Careful graft selection, individualized rehabilitation, and delayed return to sport are essential to optimize results and reduce complications. Ongoing research is needed to refine surgical strategies, compare graft types, and establish evidence-based rehabilitation and return-to-sport guidelines.
Keywords: Paediatrics, Anterior Cruciate Ligament Tears, Epidemiology, Evaluation, Evolving Treatment Strategies

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How to Cite this Article:  Weiss DL, Carr A, Berardino K, Quindlen K, Bruns RT. Paediatric Anterior Cruciate Ligament Tears: Epidemiology, Evaluation, and Evolving Treatment Strategies. International Journal of Paediatric Orthopaedics . May-August 2025; 11(2): 02-10.

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Slipped capital femoral epiphysis (SCFE) – Epidemiology, Aetiology, Pathomechanics & Outcomes

Volume 5 | Issue 1 | Jan-Apr 2019 | Page: 9-13| K Venkatadass

Authors : K Venkatadass [1]

1 Ganga Hospital Coimbatore, Tamil Nadu India

Address of Correspondence
Dr K Venkatadass

Ganga Hospital Coimbatore, Tamil Nadu India

Email: venkatpedortho@gmail.co

Abstract 

Slipped Capital Femoral Epiphysis is a common paediatric hip disease and the incidence is on rise over the years. Various epidemiological factors have been associated with it and there is also a trend of changing patterns with respect age of presentation and pathomechanics. This article primarily reviews the epidemiology, aetiology, pathomechanics and outcomes in slipped capital femoral epiphysis.

Keywords: Slipped capital femoral epiphysis, epidemiology, Pathomechanics

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How to Cite this Article: K Venkatadass. Slipped capital femoral epiphysis (SCFE) – Epidemiology, Aetiology, Pathomechanics & Outcomes International Journal of Paediatric Orthopaedics Jan-April 2019;5(1):9-13.

 

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