BACKGROUND: Anterior cruciate ligament (ACL) injuries of the knee in skeletally immature patients are increasingly prevalent, yet limited data exist regarding the mechanical properties of pediatric knee ligaments.
PURPOSE: To evaluate and compare the biomechanical properties of the ACL, posterior cruciate ligament (PCL), medial collateral ligament (MCL), lateral collateral ligament (LCL), and iliotibial band (ITB) in pediatric cadaveric knee specimens.
STUDY DESIGN: Controlled laboratory study.
METHODS: Eighteen fresh-frozen pediatric knee specimens (aged 8-12 years) underwent dissection and uniaxial tensile testing to failure. Mechanical parameters, including maximum load, stiffness, linear modulus, tensile strain, and tensile strength, were calculated. Results were analyzed using linear mixed-effects models with Tukey-adjusted P values.
RESULTS: The ITB demonstrated comparable mechanical properties to the ACL and MCL. The ITB also exhibited lower stiffness than the PCL (P = .004) and a higher maximum load than the LCL (P = .001).
CONCLUSION: The ITB shows biomechanical properties similar to the ACL and MCL, supporting its use as a graft in pediatric knee ligament reconstruction. These findings enhance the understanding of pediatric ligament mechanics and inform graft selection in surgical planning.
CLINICAL RELEVANCE: The study highlights the ITB's biomechanical similarity to the ACL, informing graft selection for ACL reconstruction in pediatric patients.