Complications and Pitfalls of ACL Reconstruction and Graft Failure in Young Athletes

Anterior cruciate ligament injury and subsequent reconstruction surgery are becoming more common among young athletes in the setting of early sports specialization, intensive involvement, and year-round training. Children and adolescents have a higher rate of graft failure compared to adults and this may be due to differences in graft choice, surgical technique, timing of surgery, neuromuscular development, psychological readiness, compliance with physical therapy, and/or longer duration of exposure to high-risk activities. The purpose of this article is to discuss potential complications and pitfalls of anterior cruciate ligament reconstruction as well as methods to decrease the risk of graft failure in young athletes.