AANA25 Knee Access Pass-CONCURRENT SESSION 3C: Pediatric Knee Solutions

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Video Summary

The session, moderated by Dr. Steve Aoki, focused on pediatric knee solutions, covering ACL reconstructions, patellar instability, chondral injuries, and injury prevention. Dr. Aoki emphasized understanding knee physis anatomy critical for surgical planning to minimize growth disturbances, citing imaging and growth assessment techniques.<br /><br />Dr. Crystal Perkins presented a study on quadriceps tendon autograft ACL reconstructions in adolescents, noting a 9% graft failure and 7% contralateral ACL tear rate over three years, with younger males at higher risk. She detailed surgical technique refinements, including graft sizing and hyperextension bracing to reduce complications like arthrofibrosis.<br /><br />Jeremy Burnham discussed the single-leg step-down test as a practical, reproducible screening tool linked to injury risk. Poor performance (<18 reps in 60 seconds) correlated with a 3-4 times higher risk of lower extremity injury, offering a scalable means to identify at-risk athletes for targeted interventions.<br /><br />Beng reviewed ACL reconstruction options in prepubescent patients, favoring the IT band technique over all-epiphyseal tunnels due to easier technical execution, lower growth disturbance risk, and better biomechanical outcomes. He provided detailed graft harvest and fixation methods respecting open physes.<br /><br />Emily Niu addressed patellar instability in skeletally immature patients, advocating comprehensive assessment starting with coronal and rotational alignment, trochlear morphology, and soft tissue balance. She highlighted guided growth for valgus correction, physeal-sparing medial patellar tendon realignment, soft tissue imbrication for patella alta, and MPFL reconstruction respecting physes.<br /><br />Henry Ellis discussed pediatric chondral injuries, stressing differing healing potential due to thicker unossified cartilage and subchondral bone pathology. Early fixation within 14 days yields high healing rates; suture bridge fixation is preferred over metal hardware. Alignment correction via guided growth is important adjunctive treatment.<br /><br />Overall, the experts emphasized individualized, physeal-respecting surgical techniques and comprehensive biomechanical assessment to optimize pediatric knee injury outcomes while minimizing growth complications. The discussion highlighted evolving strategies, the importance of early intervention, and practical injury risk assessment tools.

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Keywords

pediatric knee solutions

ACL reconstruction

patellar instability

chondral injuries

injury prevention

knee physis anatomy

quadriceps tendon autograft

single-leg step-down test

IT band technique

physeal-sparing surgical techniques