ACL Injury in Children and Teens
What is it?
The anterior cruciate ligament (ACL) is a commonly injured ligament in the knee. The ACL works to stabilize the knee and plays an especially important role when performing activities which require quickly changing direction, such as soccer, football and basketball.
Athletes who have torn their ACL sometimes report a sensation of their knee “giving out." Short term, this makes it difficult to play sports. Long term, it is believed that this “giving out” causes damage to other structures in the knee, including the cartilage, which can cause arthritis. In young people, we believe that surgical reconstruction is the best treatment for long-term preservation of the knee and for young athletes to make an early return to sports. See what an injury to the ACL looks like.
Why come to The Children’s Hospital for treatment of this condition?
There are special considerations for treating young people who tear their ACL since they are still growing. At The Children’s Hospital, we specialize in techniques designed to minimize the risks involved with treating this injury in growing children, as well as maximize their return to competitive athletics.
In addition, Children’s has the only sports medicine program in Colorado that is focused solely on caring for young athletes. Our team of sports medicine experts understand the demands that sports programs place on school-aged athletes and the importance of customized, age-appropriate care.
Our pediatric specialists are fellowship-trained in sports medicine, giving them the focused expertise that makes The Children's Hospital the best choice for young athletes looking to maximize performance after recovering from a sports injury.
What are the signs and symptoms?
Many ACL injuries occur while playing sports, but not necessarily from a violent collision. In fact, most ACL injuries are what we call “non-contact,” meaning they occur during a sudden change in direction, not when struck by another player.
Athletes who have suffered an ACL injury typically experience rapid swelling of the knee - within 24 hours of the injury. Some may be able to walk after the injury, or even continue play their sport. Many people report that they hear or feel a “pop” in their knee when the injury occurs. As the swelling subsides over the following days to weeks, most people notice that their knee feels unstable or “gives out.”
How do you diagnose it?
ACL injuries are diagnosed by a physical examination to assess the stability of the knee. X-rays are important to distinguish between a torn ACL or a fracture, as they can have similar symptoms. Magnetic resource imaging (MRI) is also helpful because it is able to check for damage to other ligaments and cartilage in the knee.
How do we treat it?
Although non-surgical treatment is an option, such as knee-bracing and physical therapy, it is generally not the treatment of choice for young people. Young people who choose not to undergo surgical reconstruction tend to experience continued episodes of their knee “giving out” and long term knee problems.
In general, we recommend a knee operation to make a new ACL out of another tendon. There are several different choices for the new ACL, which your surgeon will discuss with you. An important consideration for ACL surgery in children and adolescents is that their bones are still growing. Bone growth comes from the growth plates, which are at the ends of the bones and increase the length of the bone. Traditional ACL surgery puts these structures at risk for causing a limb length discrepancy or a deformity. At The Children’s Hospital, we specialize in surgical techniques to minimize this risk and maximize the return to competitive athletics.
Who gets it, and can it be prevented?
Anyone can suffer an ACL injury, however proper training can help to minimize the risk in athletes. Females are approximately six times more likely to tear their ACL than males. The various reasons behind this fact range from differences in bone structure to muscle imbalances.
There is some research that shows that females who participate in training programs to help strengthen specific muscles may decrease their risk of ACL injury. The Children’s Hospital offers the Sportsmetrics Program, which helps young athletes avoid injuries. Contact the Sports Medicine program at (720) 777-3899 to learn more, or e-mail us for more information.
