Paediatric ACL injuries: The 2018 IOC consensus statement
This 2018 consensus statement was formed by the International Olympic Committee. It provides a comprehensive, evidence-informed summary regarding the prevention, diagnosis and management of paediatric ACL injuries.
Clinicians have a responsibility to actively advocate for injury prevention programs early during childhood development and for children who return to sport after an injury. The FIFA 11+ For Kids is suggested for the paediatric population.
It is advised to consider ordering plain knee radiographs for all paediatric patients with an acute knee haemarthrosis to rule out paediatric fractures. Moreover, MRI should be performed to confirm the diagnosis of ACL injury and evaluate other soft tissue structures. It is important to rule out meniscal injuries as meniscal repair should be performed whenever possible in the paediatric patient.
Clinicians should be committed to protecting the long-term welfare of the growing child and utilise shared decision making for management options based on the assessment of risks and benefits and the goals of the child and parent.
Risks associated with ACL reconstruction need to be considered including possible growth disturbance. Surgery can be delayed until the child has reached skeletal maturity. Non-surgical treatment is a viable and safe option in skeletally immature patients who do not have associated injuries or major instability.
The statement includes recommendations of outcome measures specific for paediatric patients, including the Pedi-IKDC or KOOS-Child and the Pediatric Functional Activity Brief Scale.
The key components of high-quality rehabilitation for the child with ACL injury, and the options for ACL reconstruction with 3 possible surgical techniques are described in detail in this article in the British Journal of Sports Medicine, of which the full text can be accessed online here.
> From: Ardern et al., Br J Sports Med (2018-03-16 14:35:40) (Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.