ACL Research Retreat IX Summary Statement: The Pediatric Athlete, March 17–19, 2022; High Point, North Carolina

Abstract

This meeting brought together clinicians and researchers to present and discuss recent research advances across the entire anterior cruciate ligament (ACL) injury continuum to include primary, secondary, and tertiary risk identification, outcomes, and prevention strategies. An illustration of this continuum was provided in the 2019 ''Anterior Cruciate Ligament Research Retreat VIII Summary Statement.'' 1 The unique focus of the current meeting was the pediatric athlete (aged 8 to 18 years). We have seen rising numbers of ACL injury diagnoses and ACL reconstructions (ACLRs) in this age group over the past 3 decades, 2-5 and these increases were substantially greater than in older age groups. Epidemiologic studies consistently indicated that few ACL injuries occurred before the age of 10 and then they increased rapidly and steadily from age 11 to 17 years, 2,6-8 when girls developed a 3-fold to 4-fold greater risk than similarly trained boys. 9,10 Moreover, young girls were more likely to incur a second ACL injury soon after returning to sport participation. 11-14 Thus, evidence-based screening and strategies to mitigate the risk of both primary and secondary injuries and improve long-term outcomes are critically needed in this age group. Because many risk factors associated with ACL injury develop or change during physical maturation, we sought to understand the maturational biopsychosocial factors that contribute to primary and secondary ACL injuries and affect both short-term and long-term joint health.To provide a framework for the meeting and our discussions, we introduced a theoretical risk factor model (Figure) to connect the initial risk of ACL injury to longterm knee-joint-related disability, such as posttraumatic osteoarthritis (PTOA). As the model suggests, at several key time points, targeted screenings and interventions may mitigate the risk of primary ACL injury and secondary ACL injury and the subsequent risk of PTOA. To that end, ACL Research Retreat IX featured 3 keynote presentations and 42 platform presentations that provided new insights to inform ACL injury risk and prevention across this continuum.

ACL Injury Prevention Education Improves Implementation of Neuromuscular Training Among High School Sports Coaches: A Cross-Sectional Survey Study

“…In addition, 50% to 90% of all individuals who suffer an ACL injury will develop post-traumatic osteoarthritis [40], while more than 75% of ACL injuries among high school sports participants result in surgical intervention [14]. To address these issues, sports medicine organizations and researchers have called for sports coaches to adopt injury prevention programs (IPPs) that include neuromuscular training (NMT) [29,36].…”