Text

Objectives and questions: To describe the demographic and injury-related characteristics of pediatric and adolescent patients included in the Pediatric Anterior Cruciate Ligament Monitoring Initiative (PAMI) registry.

Material and methods: This observational registry study analyzed prospectively collected data from 330 patients (247 male, 83 female) aged 6–17 years with MRI-confirmed ACL injuries between 2018 and 2024. Data on demographics, injury mechanism, chronological and skeletal age were extracted. Normality of continuous variables was assessed with the Shapiro–Wilk test, and descriptive statistics are reported as mean ± SD or median with interquartile range (IQR).

Results: The mean chronological age at injury was 12.5 ± 2.1 years (n=330), with a mean skeletal age of 13.3 ± 2.0 years (n=167). Overall, 75% of patients were male, and injuries were evenly distributed between left (50%) and right (50%) knees. Sport was the leading cause of injury (90.3%), with non-contact mechanisms accounting for 74.2%. The most frequent sports were football (46%), alpine skiing (16%), and trampolining (6%). Girls sustained injuries at a younger age than boys (median 12.0 [IQR 11–13] vs. 13.0 [IQR 11–14] years).

Discussion and conclusions: As the largest prospective dataset of its kind in Europe, the PAMI registry reveals distinctive demographic patterns and injury mechanisms in pediatric ACL injuries. These insights highlight opportunities for targeted prevention, pave the way for international consensus, and support improved decision-making in this vulnerable patient group.