Participation in sports by children and adolescents has never been higher. Approximately 30 million children and youth are engaged in sports each year. But with increasing exposure to organized sports comes an increasing opportunity for injury. This issue of Sports Medicine and Arthroscopy Review provides an update of the epidemiology of injuries in the skeletally immature athlete; current information related to mechanisms of injury; and recommendations for treatment that are often unique because of the presence of an open growth plate.
Injury to the anterior cruciate ligament (ACL) does not respect an open growth plate. Although it has now been, generally, accepted that the most effective treatment of the torn ACL in the athlete is surgical reconstruction, treatment in the skeletally immature athlete, especially the prepubescent athlete, remains controversial. In this issue, Saluan reviews the short-term and long-term problems with ACL injury in kids and presents surgical methods to consider. Murray, in contrast, reminds us not to give up on the possibility of one day being able to repair the ACL, rather than reconstruct.
Comprehensive reviews are provided that focus on regions (injuries of the upper extremity, anterior knee pain, meniscus injury, injuries of the hip and pelvis, and back pain). Although osteochondritis dissecans is not unique to sport, Polousky provides a review of the current concepts of etiology, treatment, and outcome. Finally, the very basic question of “what are the physiological and psychological effects of exercise in children and youth” is addressed by Nettle and Sprogis expressed as “truth and/or consequences.”
I believe the authors have all provided extremely thoughtful and comprehensive reviews of their assigned subjects. We hope that this issue will serve as a useful resource for the practicing physician who deals with injury in the skeletally immature athlete.