APKASS 2024 consensus statement on anterior cruciate ligament reconstruction, Part I: Management of paediatric anterior cruciate ligament injury
Issued Date
2026-07-01
Resource Type
eISSN
22146873
Scopus ID
2-s2.0-105040780853
Journal Title
Asia Pacific Journal of Sports Medicine Arthroscopy Rehabilitation and Technology
Volume
45
Start Page
26
End Page
32
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asia Pacific Journal of Sports Medicine Arthroscopy Rehabilitation and Technology Vol.45 (2026) , 26-32
Suggested Citation
Wang M., Hoshino Y., Moatshe G., Wang J.H., Issaragrisil P., Mogos S., Saengpetch N., Phornphutkul C., Kim J.G., Kuroda R., Kulkamthorn N., Koga H., Otsuki S., Akagi R., Lee S.H., Eriksson K., Yoon K.H., Chernchujit B., Keyurapan E., Raoulis V., Siebold R., Ng J.P., Yung P.S.H., Ong M.T.Y. APKASS 2024 consensus statement on anterior cruciate ligament reconstruction, Part I: Management of paediatric anterior cruciate ligament injury. Asia Pacific Journal of Sports Medicine Arthroscopy Rehabilitation and Technology Vol.45 (2026) , 26-32. 32. doi:10.1016/j.asmart.2026.05.007 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117167
Title
APKASS 2024 consensus statement on anterior cruciate ligament reconstruction, Part I: Management of paediatric anterior cruciate ligament injury
Author's Affiliation
Samsung Medical Center, Sungkyunkwan university
Siriraj Hospital
Osaka Medical and Pharmaceutical University
Graduate School of Medicine
Chinese University of Hong Kong, Faculty of Medicine
Graduate School of Medical and Dental Sciences
Faculty of Medicine, Chiang Mai University
Kyung Hee Medical Center
Södersjukhuset
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Norges Idrettshøgskole
University Hospital of Larissa
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
ATOS Praxisklinik Heidelberg
Bangkok Hospital Medical Center
Oyumino Central Hospital
Nord Hospital
Myongji Hospital
Siriraj Hospital
Osaka Medical and Pharmaceutical University
Graduate School of Medicine
Chinese University of Hong Kong, Faculty of Medicine
Graduate School of Medical and Dental Sciences
Faculty of Medicine, Chiang Mai University
Kyung Hee Medical Center
Södersjukhuset
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Norges Idrettshøgskole
University Hospital of Larissa
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
ATOS Praxisklinik Heidelberg
Bangkok Hospital Medical Center
Oyumino Central Hospital
Nord Hospital
Myongji Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The greater training load and early specialization in youth sports has led to an alarming increase in knee injuries, particularly anterior cruciate ligament (ACL) injuries among children and adolescents. This study aimed to develop a consensus among surgeons and experts from the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) on key aspects of paediatric ACL injury management to enhance clinical outcomes. Methods: Twenty-three expert surgeons from 8 countries participated in the consensus meeting, which focused on nine crucial domains: prevention, diagnosis, management, surgical techniques, post-operative care, management of associated injuries, rehabilitation, outcome evaluation, and future directions. A predefined agreement threshold of 75% was used to determine consensus. Responses were analysed alongside current literature to pinpoint areas of agreement and divergence. Results: The consensus project revealed strong agreement on several key aspects of paediatric ACL injury management, particularly the implementation of injury prevention programmes for high-risk sports (85%) and the importance of assessing concomitant meniscal or chondral injuries for surgical intervention (91.3%). However, significant variability was observed in areas such as diagnostic challenges, treatment timing, and rehabilitation protocols. There was no consensus on optimal surgical techniques for skeletally immature patients or the ideal graft diameter for reconstruction. Individualized treatment approaches were emphasized, with 78.3% of surgeons advocating for case-by-case decision-making, reflecting the need to consider factors like skeletal maturity, activity level, and family preferences. There was also a strong consensus on the need for routine monitoring of growth disturbances post-surgery and a comprehensive multi-criteria approach for return-to-sport assessments, underscoring the complexity of managing paediatric ACL injuries. Conclusion: This expert consensus, developed from an Asia-Pacific perspective, showed both agreement and variation in managing paediatric ACL injuries. While strong consensus was achieved on diagnostic and immediate post-injury care, differences remained in surgical timing, graft selection, and rehabilitation. These findings highlight the need for region specific and paediatric focused guidelines to optimise long term outcomes and establish standardised evaluation criteria for this unique population. Level of evidence: V (Expert opinion).