The correct surgical approach for a skeletally immature athlete with an ACL tear remains controversial. Transphyseal ACL reconstruction with a soft tissue autograft is a popular choice that most resembles the technique performed in adults. However, crossing an open growth plate comes with risk of growth arrest, though the frequency and magnitude of that risk is not well known. We thank Drs. Alexander Seeto, MD and Ivan Astori, MBBS for their discussing their findings with us.