The Paediatric ACL National Audit (PANA) study: a multicentre review of UK practice and adherence to BOAST guidelines
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Paediatric ACL injuries are increasingly common and present significant challenges. Inappropriate treatment can lead to long-term complications like instability, growth disturbance, and osteoarthritis. The Paediatric ACL National Audit (PANA) Study assesses UK practices and adherence to Best Orthopaedic Practice (BOAST) guidelines for managing these injuries, identifying opportunities to improve care for young patients. METHODS: PANA was a collaborative audit of 22 hospitals in England, Wales, and Scotland, measuring adherence to BOAST guidelines in treating paediatric ACL injuries. Orthopaedic surgeons and trainees collected data through a secure online questionnaire about service provision for skeletally immature patients, including diagnostic imaging, rehabilitation, post-operative follow-up, and surgical techniques. RESULTS: Our analysis revealed variability in adherence to the BOAST guidelines for ACL injuries in paediatric patients, with 65% of centres using acute knee pathways and 68% utilising collaborative imaging pathways. About 59% of centres conduct radiological growth monitoring, while only 30% report functional outcomes. Less than 50% report re-rupture rates, and 74% adhere to rehabilitation protocols. CONCLUSION: The rise in ACL injuries in the paediatric population highlights the need for standardised care delivery and reporting. Following the release of the BOAST guidelines in 2022, this nationwide audit has revealed discrepancies in UK practices. A multidisciplinary approach is essential for improving patient care and outcomes by standardising and promoting best practice.
Source: The Knee
Authors: Benjamin D. Gompels, Alagu Subramanian, Ilias E. Epanomeritakis, Daniel Hide, Michael Daniel Collins, Thomas Molloy, Florence Bradshaw, Simone Castagno, Ignatius Liew, William Nabulyato, Chinmay Gupte, Nicolas Nicolaou, Stephen M. McDonnell, Alexandra Macmillan, Pranai Buddhdev, Michael Wilson, Ben Marson, Dev Hitesh Thakker, Nathanael Ahearn, Rakan Kabariti, Alexander Glover, Emily London, Caroline Hing, Mahak Baid, Roshana Mehdian, Dimitrios Manoukian, Ran Wei, Nima Razii, Innes D.M. Smith, Wai Huang Teng, Tim Lindsay, Lysander James Gourbault, Robert Whitham, Chryssa Neo, Simon John Federer
Institutions: University of Cambridge, Addenbrooke's Hospital, Hammersmith Hospital, Imperial College London, Sheffield Children's NHS Foundation Trust, Sheffield Children's Hospital, South London Healthcare NHS Trust, Mid Essex Hospital Services NHS Trust, University Hospitals Dorset NHS Foundation Trust, Birmingham Children's Hospital, Royal Surrey NHS Foundation Trust, Torbay and South Devon NHS Foundation Trust, Robert Jones and Agnes Hunt Orthopaedic Hospital, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, The Royal Free Hospital, St George's Hospital, St George's Hospital, Aneurin Bevan University Health Board, St Helier Hospital, Barts Health NHS Trust, Royal London Hospital, NHS Greater Glasgow and Clyde, Lewisham and Greenwich NHS Trust, Chelsea and Westminster Hospital NHS Foundation Trust, Somerset NHS Foundation Trust, University Hospitals Sussex NHS Foundation Trust
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,820
OpenAlex ID: W7131399239