Sport injuries are becoming more common in children as the length of sports seasons increase and the level of play intensifies. Anterior cruciate ligament (ACL) tears — once thought to be primarily an adult injury — now are routinely seen in Children's pediatric orthopedic clinics.
Middle school-age girls playing high-level soccer and basketball appear to be particularly vulnerable to ACL tears, sustaining four to eight times as many ACL disruptions as boys of the same age. Falling from a bicycle or twisting during play can also produce an ACL tear.
After an ACL tear, the knee may be swollen or feel tender. To diagnose ACL injuries, a physical exam and radiographs are necessary; an MRI might be useful. Although medications can help decrease the pain, ignoring the injury may result in worse damages.
Treating ACL tears begin with exercise. Many young people find that no further intervention is needed when they follow a guided exercise program that includes strengthening and balance training. However, the majority of young athletes have persistent instability that requires surgery.
Pediatric specialists have special expertise working with developing bodies to heal ACL tears. They modify the surgical technique to limit the risk of injury to the growth plate (area of developing tissue on either end of the growing bone).
We perform procedures … designed to preserve growth while optimizing function of the knee.
Dr. Gregory Schmale
"At Children's, we perform procedures around and through the growth plates in a fashion designed to preserve growth while optimizing function of the knee," says Dr. Gregory Schmale, director, Sports Medicine Program, Orthopedics.
"Children with open growth plates benefit from ACL reconstruction when their knee remains unstable despite a trial of therapy.
The technique used for reconstruction should minimize risk of injury to the growth plate. Performing routine adult-style ACL reconstructions can lead to growth-plate injury and abnormal growth of the limb, including angulation at the knee and a difference in leg lengths."
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