Abstract
Background or Purpose: Managing ACL tears in the skeletally immature patient is a complicated and at times challenging undertaking. As such, it should be undertaken only by a surgeon with experience treating pediatric and adolescent injuries of this nature. Methods: Two basic choices exist: (1) conservative management with or without delayed reconstruction or (2) early reconstruction. While data can be found to support both modes of care, an overwhelming preponderance of the literature supports early operative intervention for complete ACL tears in this population. Results and Conclusions: Operative intervention has consistently been shown to increase knee stability and decrease the risk of further damage to the meniscus and articular cartilage with minimal risk of growth disturbance. Conservative or delayed operative care should only be considered in the most compliant patients with uncomplicated injuries. As there is little data supporting one surgical technique as superior, patient age and surgeon familiarity and comfort should guide the choice. This paper aims to address the natural course of ACL injuries in the skeletally immature patient, treatment options with associated complications, and current preventative strategies