Current concept on assessment and management of anterior cruciate ligament injury in skeletally immature athletes

The incidence of anterior cruciate ligament (ACL) injuries in paediatric and skeletally immature patients is rising, proportionally to the worldwide spread of sport participation. However, differently from adults, injuries in young patients pose serious challenges regarding their management, especially when surgery is required. To date, controversies remain regarding the indications, timing of surgery and techniques for ACL reconstruction. This current concept provides a deep and detailed theoretical background of ACL injury and management in patients with open physis. Moreover, a practical algorithm of treatment is provided based on authors' experience and research and current evidence-based medicine (EBM). To optimise management and reduce the risks of either conservative or surgical treatment, a deep knowledge of the specific concepts related to paediatric patients is required. Level of Evidence: Level V.