CC2021: Early Operative Versus Delayed Operative Versus Nonoperative Treatment of Pediatric and Adolescent Anterior Cruciate Ligament Injuries (December 2021)-CC2021: Early Operative Versus Delayed Operative Versus Nonoperative Treatment of Pediatric and Adolescent Anterior Cruciate Ligament Injuries (December 2021)

CC2021: Early Operative Versus Delayed Operative Versus Nonoperative Treatment of Pediatric and Adolescent Anterior Cruciate Ligament Injuries (December 2021)

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The optimal treatment strategy for anterior cruciate ligament (ACL) injuries in pediatric and adolescent patients remains a topic of debate. This systematic review and meta-analysis aimed to determine the effectiveness of different treatment options for ACL injuries in this population. The study included a total of 30 studies representing 1,176 patients.<br /><br />The findings of the study suggest that early ACL reconstruction in pediatric and adolescent patients is associated with a lower risk of meniscal tears and irreparable meniscal tears compared to delayed reconstruction. However, there was no significant difference in knee stability or patient-reported outcomes between early and delayed reconstruction.<br /><br />Nonoperative management of ACL injuries in this population resulted in high rates of residual knee instability, an increased risk of meniscal tears, and low rates of return to sports.<br /><br />It is important to note that the quality of the included studies varied, with most being retrospective case series. Additionally, there was heterogeneity in surgical techniques, graft choices, and follow-up durations among the studies. The lack of prospective randomized comparative studies limits the strength of the conclusions drawn.<br /><br />Overall, the study suggests that early operative intervention, specifically ACL reconstruction within 12 weeks of injury, may be beneficial in pediatric and adolescent patients with ACL injuries. However, further research, particularly in the form of long-term prospective comparative studies, is needed to fully understand the optimal treatment strategy for ACL injuries in this population.

Keywords

ACL injuries

pediatric patients

adolescent patients

treatment options

systematic review

meta-analysis

ACL reconstruction

meniscal tears

knee stability

patient-reported outcomes