ACL Research Retreat IX Summary Statement: The Pediatric Athlete, March 17-19, 2022; High Point, North Carolina

The incidence of ACL injuries in young athletes has increased over the last 3 decades, with girls showing the greatest increases.2 As athletes reach their mid-teens and progress into later maturational stages, sport-related ACL injuries continue to rise. Therefore, the early to mid-teens would appear to be an optimal window for injuryprevention interventions compared with targeting the late teens and early adult years.35 A primary take-home message from the discussions of primary risk was the importance of continued efforts to recognize the earliest onset of risk development at the individual level, so that we can determine the optimal window and targets for interventions. It is also becoming increasingly evident that we must move beyond physical risk assessment and address cognitive factors as well. Still, despite our best preventive efforts, some individuals will go on to experience ACL injuries. Attendees at this meeting identified a number of key directions for future research in the areas of primary and secondary risk-factor identification and optimizing interventions for reducing secondary injury while ensuring the best outcomes for long-term joint health. Specific to the prevention of secondary ACL injury, we need more evidence-based return-to-play criteria and a greater emphasis on psychological readiness. Psychosocial factors relative to the onset and progression of OA were considered, as were interventions for slowing or mitigating this disease. In summary, it is important to focus on the whole person and individual-level factors as ACL injury research continues to evolve.