AOSSM Youth to the NFL Sports Medicine Course with CME-Young Football ACL

Video Transcription

Video Summary

In this video, the speaker discusses ACL tears in skeletally immature patients and the evolution of treatment options over time. Traditionally, surgery for ACL tears in young patients was rare, and they would be managed with braces, physical therapy, and activity modification until reaching skeletal maturity. However, studies in the 90s and 2000s showed that delaying surgery led to high rates of meniscus and chondral injuries that caused permanent joint damage. A director at Boston Children's performed the first IT band ACL reconstruction in a three-year-old with congenital absence of the ACL, which eventually led to the development of a modified technique that included an intra-articular component. This procedure was initially used as a temporary solution, but it was found that patients maintained stability into adulthood. Rehab for this technique involved protective measures and a slightly shorter recovery time compared to the standard ACL reconstruction. The speaker describes the use of an algorithmic approach for different age groups, with prepubescent patients receiving a FICIS-sparing ACL reconstruction, pubescent adolescents with growth remaining receiving a FICIS-respecting ACL reconstruction, and older adolescents receiving adult ACL reconstructions. The speaker also mentions alternative techniques such as all-epiphyseal and partial trans-physeal ACL reconstructions, and discusses safety and effectiveness, graft options, and potential disadvantages of these techniques. The presentation concludes with a discussion of ongoing studies and future research directions.

Asset Caption

Presented by Benton E. Heyworth MD

Keywords

ACL tears

skeletally immature patients

treatment options

ACL reconstruction

surgical techniques