{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:08:02Z","timestamp":1787162882519,"version":"build-2736575974"},"reference-count":57,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100010975","name":"Pediatric Orthopaedic Society of North America","doi-asserted-by":"publisher","award":["2015 - Arthur H. Huene Memorial Award"],"award-info":[{"award-number":["2015 - Arthur H. Huene Memorial Award"]}],"id":[{"id":"10.13039\/100010975","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cruciate ligament (ACL) injuries are common in pediatric and adolescent patients. Understanding this population\u2019s injury characteristics and treatment strategies is vital for managing this high-risk group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To report the descriptive epidemiology and treatment strategies of a large cohort of skeletally immature patients with complete ACL tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Consecutive skeletally immature patients diagnosed with complete ACL tears were enrolled at 10 institutions across the United States. Treatment was provided by 1 of 23 participating orthopaedic surgeons. Patient characteristics (chronological and skeletal age, sex, race, and ethnicity) as well as anthropometric measures, mechanism of injury, and ACL treatment type were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 749 skeletally immature participants were included in the final cohort; the mean chronological age was 12.9 years, and 62% were male. The mean skeletal age (13.2 years) was a mean of 0.34 years (4 months) higher than the mean chronological age (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Tanner staging revealed that 18% of participants were Tanner stage 1, 20% were Tanner stage 2, 28% were Tanner stage 3, 30% were Tanner stage 4, and 4% were Tanner stage 5. Five percent of participants reported a previous ipsilateral knee injury, and 30% had a family history of ACL injuries. Sport was the predominant mechanism of injury (89%), with noncontact injuries the most common (64%). The most common sport resulting in an ACL tear among boys was American football (41%) and among girls was soccer (44%). Overall, 99.9% of skeletally immature patients were treated surgically by 1 of 4 reconstruction techniques: transphyseal (53%), partial transphyseal (7%), physeal-sparing all-epiphyseal (13%), and physeal-sparing iliotibial band (ITB) (27%). The most common surgical techniques for patients with a skeletal age &lt;13 years were physeal sparing with ITB (56%) and all-epiphyseal (22%), while in patients with a skeletal age \u226513 years, transphyseal (71%) and physeal sparing with ITB (12%) were the most common. Overall, 57% of patients who underwent ACL reconstruction had arthroscopically documented meniscal tears, with high rates of meniscal repair (90% medial tears and 66% lateral tears).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Almost all skeletally immature patients with ACL tears were injured during sports, surgical treatment was overwhelmingly the treatment of choice, and preferred surgical techniques varied based on skeletal ages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241312215","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T13:49:26Z","timestamp":1738158566000},"page":"612-622","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Descriptive Epidemiology of Complete ACL Tears in the Skeletally Immature Population: A Prospective Multicenter PLUTO Study"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5003-7632","authenticated-orcid":false,"given":"Melissa A.","family":"Christino","sequence":"first","affiliation":[{"name":"Investigation performed at Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Investigation performed at Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8628-5603","authenticated-orcid":false,"given":"Andrew T.","family":"Pennock","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, University of California\u2013San Diego, San Diego, California, USA"},{"name":"Investigation performed at Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle L.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Investigation performed at Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian N.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Tennessee Orthopaedic Alliance, Nashville, Tennessee, USA"},{"name":"Investigation performed at Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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