Youth athletes are experiencing tears of a knee ligament at alarming rates. These injuries, known as anterior cruciate ligament (ACL) injuries, occur with sports that involve pivoting and side-to-side motions, like soccer and skiing. Because the young athletes are often still growing, orthopaedic specialists must take special care. Treatment should control long-term damage and prevent debilitating conditions like arthritis while also protecting future growth.
Related post: ACL tears in young athletes at epidemic levels
Treating ACL injuries
If an orthopaedic specialist diagnoses your child with an ACL tear, both nonsurgical and surgical treatment options may be available:
A nonoperative approach may be the best treatment course if your child doesn’t have any other cartilage damage that needs immediate attention. Historically, young people up to age 11 who had a lot of growing left to do were managed nonsurgically because of concerns that surgery could affect future growth. This treatment approach includes physical therapy to strengthen the muscles that support the knee, like the hamstring and quadriceps.
The downsides to nonoperative management include:
Today, leading-edge techniques allow orthopaedic surgeons to operate without jeopardizing future growth. Surgical treatment for ACL injuries in youth athletes often makes sense because:
ACL tears are not like skin tears: They can’t be sewn back together and don’t heal on their own. The longer a patient lives with an ACL tear, the less likely it is that a surgeon can fix it. To repair an ACL, a surgeon has to reconstruct a new ligament. Two standard reconstruction options are:
Is your child’s knee ready for surgery?
Before undergoing surgery, your child’s knee must be ready. Surgeons allow at least two weeks between when the injury occurs and surgery to repair an ACL. While children are anxious to get back on the field, waiting is vital to reduce the likelihood of complications.
Surgeons want to see that:
Surgeons pay close attention to skeletal maturity when determining if a patient is ready to undergo surgery. They want to assess how much growth potential remains. The majority of growth in the leg comes from the growth plates around the knee — the end part of the thigh bone and the top part of the shin bone. Surgeons must be very careful not to disturb those growth plates during surgery.
In many cases, orthopaedic surgeons encourage youth athletes to go through “pre-hab,” which is an initial rehabilitation phase before surgery. Pre-hab reduces the rate of postsurgical complications. It may involve home exercises or working with a physical therapist or strength and conditioning coach.
After surgery, your child should begin physical therapy within days. Starting rehab right away delivers the best results.
Questions to ask your child’s orthopaedic surgeon
These questions can determine if an orthopaedic surgeon is the right one to treat your child:
The Center for Sports Medicine helps young athletes return to his or her sport quickly and safely.