Early ACL reconstruction in children leads to less meniscal and articular cartilage damage when compared with conservative or delayed treatment

Abstract

Background Anterior cruciate ligament (ACL) tears are being seen and treated with increasing frequency in children and adolescent athletes. The superiority of treating ACL tears in children and adolescents with acute reconstruction, delayed reconstruction or non-operative treatment remains controversial. Objectives To perform a systematic literature review to investigate for any associations between progressive intra-articular joint damage (increasing rates of meniscal and cartilage injury) with delayed or non-operative treatment of ACL tears in children and adolescents under age 18 when compared with acute ACL reconstruction (ACLR). Data sources PubMed, EMBASE and Cochrane computerised databases. Study eligibility criteria Inclusion criteria: (1) paediatric patient population (defined as <18 years of age), (2) investigated association between operative or non-operative treatment and consequent meniscal/ chondral injury rates, (3) original research article, rather than a review, case report or meta-analysis. Exclusion criteria: (1) revision ACL cohort, (2) full-text article in a language other than English and (3) not a human clinical study. Participants Youth aged <18 years with ACL tears. Interventions Acute ACLR, delayed ACLR, nonoperative management. Synthesis methods Qualitative synthesis.