# Current concept on assessment and management of anterior cruciate ligament injury in skeletally immature athletes

**Authors:** Alberto Grassi, Kyle Borque, Claudio Rossi, Bruna Cascone, Francesco Della Villa, Stefano Zaffagnini

PMC · DOI: 10.1002/jeo2.70498 · Journal of Experimental Orthopaedics · 2025-11-16

## TL;DR

This paper discusses the challenges and current approaches for managing ACL injuries in young athletes whose skeletons are still developing.

## Contribution

The paper provides a detailed theoretical background and a practical treatment algorithm for ACL injuries in skeletally immature patients.

## Key findings

- ACL injuries in skeletally immature patients require specialized management due to unique challenges.
- Controversies remain regarding the timing and techniques for ACL reconstruction in young patients.
- A practical treatment algorithm is proposed based on current evidence and clinical experience.

## Abstract

The incidence of anterior cruciate ligament (ACL) injuries in paediatric and skeletally immature patients is rising, proportionally to the worldwide spread of sport participation. However, differently from adults, injuries in young patients pose serious challenges regarding their management, especially when surgery is required. To date, controversies remain regarding the indications, timing of surgery and techniques for ACL reconstruction. This current concept provides a deep and detailed theoretical background of ACL injury and management in patients with open physis. Moreover, a practical algorithm of treatment is provided based on authors' experience and research and current evidence‐based medicine (EBM). To optimise management and reduce the risks of either conservative or surgical treatment, a deep knowledge of the specific concepts related to paediatric patients is required.

Level V.

## Full-text entities

- **Diseases:** ACL injury (MESH:D000070598)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12620561/full.md

## Figures

18 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12620561/full.md

## References

89 references — full list in the complete paper: https://tomesphere.com/paper/PMC12620561/full.md

---
Source: https://tomesphere.com/paper/PMC12620561