AANA19 Knee Access Pass-Procedure Choice in the Skeletally Immature-Dr. Todd Lawrence, M.D.

Procedure Choice in the Skeletally Immature-Dr. Todd Lawrence, M.D.

Video Transcription

Video Summary

The presentation reviews pediatric ACL reconstruction, highlighting a significant shift over 15 years from conservative management to recommending surgical repair in nearly all cases. ACL injuries in kids are rising, especially in ages 11–14. Early reconstruction risks growth disturbances, while delaying surgery increases meniscal and cartilage damage. Techniques include physeal-sparing (avoiding growth plate damage) and transphyseal methods, chosen based on bone age and growth remaining. The 2019 pediatric ACL reconstruction algorithm favors the over-the-top technique for younger children and transitions to transphyseal or hybrid methods as maturity increases. Surgical approaches prioritize minimizing growth plate injury while preventing re-injury and further joint damage.

Keywords

pediatric ACL reconstruction

growth disturbances

physeal-sparing technique

transphyseal method

meniscal damage