(Ivanhoe Newswire) – As more and more children participate in competitive
sports at an increasingly early age, the incidence of knee injury has increased
accordingly. Knee injuries are especially problematic in a child under 14 whose
skeleton has not reached a mature size.
A new study explores the benefits and risks of repairing a torn anterior
cruciate ligament (ACL) in young athletes under the age of 14. "The risk of
inducing a growth disturbance with early reconstruction of a torn ACL must be
balanced against the risk of further knee damage by delaying treatment until
closer to skeletal maturity,” author, Theodore J. Ganley, MD, Director of the
Sports Medicine and Performance Center for The Children's Hospital of
Pennsylvania and the University of Pennsylvania School of Medicine is quoted as
saying. “Our study measured the independent risk factors for and relative risk
of meniscal and chondral injuries in pediatric ACL patients."
Researchers analyzed the records of 69 patients, aged 14 years and younger, who
had undergone ACL reconstruction between 1991 and 2005. All of the patients were
counseled about the benefits and risks of delaying ACL reconstruction and were
advised to avoid any at-risk activities and to participate in physical therapy
prior to their reconstruction. If the decision was made to delay treatment,
patients were instructed to wear a custom ACL brace.
All patients who underwent the surgery used a soft tissue graft with
anatomically placed tunnels and fixation devices that did not cross the growth
plate. Patients followed for a minimum of one-year post-operatively exhibited no
growth disturbances.
Patients who chose to delay treatment, however, did not fare so well. "In our
study . . . a delay in treatment of more than 12 weeks had about a four-fold
increase in irreparable medial meniscus tears, an 11-fold increase in lateral
compartment chondral injuries and a three-fold increase in patellotrochlear
injuries” said Ganley. “Issues with instability in the knee were also increased
significantly. Our results highlight and help quantify the risk associated with
delaying ACL reconstruction in young athletes and the need for continued injury
prevention efforts.”
SOURCE: Presented at the American Orthopaedic Society for Sports Medicine's (AOSSM)
Annual Meeting in Keystone, Colorado, July 9-12
