Fietsen verstandig?


Bij hardlopen wordt de knie belast met 6x uw lichaamsgewicht bij elke stap

Máxima Medisch Centrum

Value-Based Health Care

ESSKA Accredited Teacher

Orthopedie Groot Eindhoven

Goede uitleg is essentieel voor juiste keuze behandeling


Voorste kruisbandreconstructie

Achterste kruisbandletsel

Zorg op maat

YouTube kanaal dr RPA Janssen

Internationaal wetenschappelijk onderzoek

Kruisbandoperaties knie

RPA Janssen MD PhD


Waardegedreven zorg

Last van knie-artrose?

Spreekuur / Policlinique / Outpatient clinic

Nederlandse Vereniging voor Arthroscopie

Máxima Medisch Centrum

Kruisbandoperaties bij kinderen

Veel pijn bij ernstige knie-artrose?

Samen met uw arts gekozen voor een knie-operatie?

Eenzijdige knie-artrose knie en actief leven?

Máxima Medisch Centrum Eindhoven-Veldhoven

Kwaliteit van leven

Samen kiezen voor de beste behandeling

Sporten met plezier

Oplossingen voor de lange termijn

Associate Professor Knee Reconstruction


Kneecap pain is a regular occurrence in fitness knee rehabilitation

Knee osteoarthritis

Cycling wise?


When running, the knee is loaded with 6x your body weight with each step

Pediatric Anterior Cruciate Ligament (ACL) injuries

Opinions on whether pediatric ACL (anterior cruciate ligament) treatment should primarily be surgically reconstructed or conservatively treated are still divided within the pediatric orthopedic community. It is commonly believed that the incidence of pediatric ACL injuries is rising, however, only one study has documented an increase, and there are no other epidemiological studies available to support this assumption. Advances in diagnostic methods and increased awareness, in addition to earlier specialization in sports and higher numbers being active may have led to an increase in the incidence of pediatric ACL tears.

Maxima Medical Center EIndhoven-Veldhoven (The Netherlands) is a tertairy referral center for pediatric and adult ACL injuries in the Netherlands (Expertise Center for Sports and Complex Knee Ligament Injuries). 

RPA Janssen MD PhD was chair of an instructional Course Lecture on Pediatric ACL injuries at the ESSKA Congress in 2018 (Glasgow, Scotland). Together wit a team of experts, the take home messages were: 

  • Pediatric ACL tears are rare, accounting for less than 5% of all ACL injuries, and do rarely occur under the age of 9. Their current evidence for treatment is low.
  • It is imperative that the child and parents are provided with thorough information on the benefits and risks involved with both surgical and conservative treatment.
  • There is an international consensus that in case of concomitant damage to the meniscus (bucket handle or meniscal ramp lesions) and/or persistent knee instability, an ACL reconstruction should be performed. The goal is to stabilize the knee, improve its function, repair the meniscus and protect the knee from future episodes of giving way and injuries
  • According to the localization of the tibial and femoral tunnels, surgical techniques can be divided into three categories: transphyseal procedures, where the tunnels are drilled through the growth plates; epiphyseal techniques, where the tunnels are located in the tibial and femoral epiphysis, not injuring the growth plate and finally extra-epiphyseal techniques, where the graft is placed around the growth plate.
  • There is still no convincing evidence that demonstrates which technique should be used in pediatric ACL reconstruction. Most studies report very good outcome after surgery, but there is an alarming high graft rupture rate.
  • The backside of performing ACL reconstructions in skeletally immature patients is the risk of provoking a growth disturbance following transepiphyseal drilling and the unknown development of the graft with post-operative growth.
  • The use of validated PROMs for children with ACL injury may help improve the quality of clinical care for this pediatric population. Based on psychometric assessment, the Pedi-IKDC and KOOS-Child are advised for patients’ age 6-18 years with ACL injury.

See Publications for references.