CORR Insights^®: Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Excerpt

Compelling data support our current understanding of ACL injuries and associated pathologies in the adolescent athlete. These data confirm that among athletic adolescent patients treated nonoperatively for complete ACL tears, the frequency of meniscal and chondral damage from recurrent episodes of instability is high [1, 3‐8, 16‐18]. Additionally, delay in surgical treatment of as little as 12 weeks leads to increasing numbers of irreparable medial meniscus tears and lateral compartment articular cartilage injuries [11]. Historically, there has been a controversy regarding balancing the risks associated with delay in surgery with the risks of physeal injury and growth disturbance during surgical reconstruction in the skeletally immature athlete. With improvements in surgical technique and instrumentation, the risk of growth disturbance seems lower [6, 12, 13]. As a result, many investigators in this field have concluded that for this high-risk group of both skeletally immature and mature adolescent athletes, the “conservative treatment” in most patients actually is ACL reconstruction. The challenge is to define more effectively the population at risk, and to identify the small subgroup of adolescents who may benefit from nonoperative treatment. …