2022 AOSSM Annual Meeting Recordings with CME-ACL Decision Making for the Skeletally Immature

Video Transcription

Video Summary

In this video, a physician specializing in pediatric sports medicine discusses the importance of addressing physis (growth plate) concerns in pediatric ACL (anterior cruciate ligament) reconstruction. The speaker highlights a study that found growth disturbances, such as valgus (inward angling) deformities and limb length discrepancies, associated with surgical treatments using rigid fixation across the physis. However, delaying ACL reconstruction until skeletal maturity has also been shown to lead to secondary meniscal injuries and lower rates of return to sport. The speaker emphasizes the need to consider skeletal age and growth remaining when choosing treatment techniques. They discuss several techniques, including extra-facial reconstruction, all epiphyseal reconstruction, hybrid or partial trans-facial reconstruction, and trans-facial reconstruction, each with their own benefits and complications. The speaker also briefly mentions graft choice, favoring soft tissue grafts over allografts and highlighting the rise in quad grafts. Additionally, the speaker mentions the use of lateral extra-articular procedures in certain cases. Overall, the speaker provides an overview of considerations and treatment options for pediatric ACL reconstruction. No credits were mentioned.

Asset Caption

Crystal Perkins, MD

Keywords

pediatric sports medicine

physis concerns

pediatric ACL reconstruction

growth disturbances

skeletal age