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ACL Tear: Management in Skeletally Immature Athletes, Sports Medicine

Holly J. Benjamin, MD, FAAP, FACSM and Michael Ladewski, DO Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Acute injury sustained by known mechanism that leads to knee instability with significant effect on the athlete’s ability to perform at the highest levels of sport

  • Considerable variat...

DIAGNOSIS

HISTORY

  • May be a “pop” sensation at the time of injury

  • Effusion usually develops acutely.

  • Athlete unable to continue play

  • Instability of knee after injury

PHYSICAL EXAM

  • It can be difficult to perf...

TREATMENT

GENERAL MEASURES

  • Compression

  • Ice

  • Pain management

  • Weight-bearing as tolerated unless physeal fracture is suspected

  • Therapeutic aspiration can be performed on the hemarthrosis.

  • If fat is noted in th...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patients will require substantial physical therapy to regain ROM and strength as well as to address functional and sports-specific mechanics to address prevention...

REFERENCES

1
Moksnes H, Engebretsen L, Eitzen I, et al. Functional outcomes following a non-operative treatment algorithm for anterior cruciate ligament injuries in skeletally immature children 12 year...

ADDITIONAL READING

  • Pennock A, Murphy MM, Wu M. Anterior cruciate ligament reconstruction in skeletally immature patients. Curr Rev Musculoskelet Med.  2016;9(4):445–453.

  • Siow HM, Cameron DB, Ganle...

CLINICAL PEARLS

  • Injury that is increasing in incidence in the skeletally immature population

  • Early surgical therapies are becoming more favorable when compared to non- or delayed surgical treatment.

  • Typ...

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