In this episode of HSS Presents, Dr. Josh Bram speaks with orthopedic surgeons Dr. Peter Fabricant and Dr. Daniel Green about ACL reconstruction in skeletally immature athletes. They explain why traditional techniques risk growth plate injury and discuss specialized physeal-sparing procedures, including the modified MacIntosh IT band technique and all-epiphyseal reconstructions. The conversation highlights patient selection, imaging strategies, and graft choices that reduce re-injury rates while protecting long-term knee health. With insights from large multicenter studies and decades of pediatric sports medicine experience, the experts share best practices for safely returning young athletes to play.