From the Guidelines
The incidence of anterior cruciate ligament (ACL) injuries in pediatric patients is approximately 3% per year in amateur athletes, with females being two to eight times more likely to sustain an ACL injury than males.
Incidence of ACL Injuries
- The incidence of non-contact ACL injuries appears to be the greatest in athletes who are between 15 and 40 years of age and participate in pivoting sports like soccer, handball, volleyball and alpine skiing 1.
- While the exact incidence of ACL injuries in pediatric patients is not explicitly stated, it can be inferred that pediatric patients, especially those participating in pivoting sports, are at a significant risk of ACL injuries.
- Females are more likely to sustain an ACL injury than males, likely due to differences in neuromuscular patterns that diverge during and following puberty 1.
Clinical Context
- ACL injuries are a common occurrence in young athletes, with many requiring surgical reconstruction to return to sports 1.
- The rehabilitation process after ACL reconstruction is crucial in minimizing the risk of reinjury and ensuring a successful return to sports 1.
- However, the provided evidence does not specifically address the incidence of ACL injuries in pediatric patients, and therefore, the exact incidence rate cannot be determined with certainty.
From the Research
Incidence of Anterior Cruciate Ligament (ACL) Injuries in Pediatric Patients
- The incidence of ACL injuries in pediatric patients is increasing, with a significant rise in diagnosis and reconstruction compared to adult patients 2.
- A study in Victoria, Australia found a 147.8% increase in the annual rate of ACL injuries in children aged 5-14 years over a 10-year period 3.
- The majority of ACL injuries in pediatric patients occur in 10- to 14-year-olds, with sporting activities accounting for 56.6% of injuries 3.
- Females are more likely to suffer ACL injuries while playing ball sports, with 52.4% of injuries occurring in this context, compared to 35.4% of males 3.
Trends and Risk Factors
- The increasing participation of children and adolescents in sports is contributing to the rising incidence of ACL injuries in this population 4, 5.
- Pediatric patients who undergo ACL reconstruction are at increased risk of contralateral ACL injury, with rates ranging from 4% to 42% 6.
- Risk factors for contralateral ACL tear include inherent anatomical differences, biomechanical and neuromuscular changes, and participation in cutting and pivoting sports 6.
- Pediatric athletes who return to sport quickly are also at increased risk of contralateral tears 6.
Management and Prevention
- Management of ACL injuries in pediatric patients can be surgical or non-surgical, depending on the severity of the tear and associated injuries 4.
- Rehabilitation plans should include strength, proprioception, and neuromuscular training to maximize recovery 4.
- Injury prevention programs, consisting of strength training and neuromuscular training, can help reduce the incidence of ACL injuries in young athletes 4, 3.