THE PAEDIATRIC ANTERIOR CRUCIATE LIGAMENT (ACL) NATIONAL AUDIT STUDY (PANA)

Paediatric anterior cruciate ligament (ACL) injuries are increasingly common and pose significant management challenges. Without proper treatment, they can lead to persistent joint instability, cumulative meniscal damage and osteoarthritis. The Paediatric ACL National Audit (PANA) Study assessed UK practices, focusing on adherence to British Orthopaedic Association Standards for Trauma and Orthopaedics (BOASts) guidelines for managing paediatric ACL injuries. The Paediatric National ACL Audit (PANA) was a collaborative audit of 22 hospitals in England, Wales, and Scotland. It measured adherence to BOAST best practice guidelines for paediatric ACL injuries. Data on service provision, including diagnostics, rehabilitation, and surgical techniques, were collected from orthopaedic surgeons and trainees via an online questionnaire. Our analysis revealed significant differences in adherence to BOAST guidelines, with 65% of centres surveyed reporting the use of acute knee pathways and 68% utilising locally collaborative imaging pathways. There was variability in post-operative monitoring, with approximately 59% of centres surveyed performing radiological growth monitoring and only 30% reporting functional outcomes post-operation. Additionally, fewer than 50% of surveyed centres reported re-rupture rates, and adherence to rehabilitation protocols was implemented in 74% of surveyed centres. This nationwide audit has found discrepancies in practices throughout the UK. Multidisciplinary MDT is essential to improving patient care and outcomes in this population by standardising practice and promoting best practices.