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Pediatric ACL Surgery

Understanding Pediatric ACL Injuries

The anterior cruciate ligament (ACL) is a key ligament in the knee that helps stabilize the joint. In young athletes, ACL injuries can be particularly challenging due to the risk of meniscus and cartilage damage which can affect the long term function of the knee.

How Injuries Happen

ACL injuries occur most commonly in patients who play sports. They can also occur with other types of trauma, such as falls or motor vehicle accidents. The most common mechanism of ACL injury is a twisting or pivoting injury on the knee, where the foot remains planted and the knee twists. It also occurs commonly when landing from a jump, when the knee buckles or twists. The patient usually feels a “pop,” when the anterior cruciate ligament tears. The knee will also usually swell up within the first twenty-four to forty-eight hours. 

How It Feels

After the knee is injured and the ACL is torn, the knee will often feel very painful due to the ligament injury and the swelling. Most patients have difficulty walking after a tear of the anterior cruciate ligament. Patients may also feel knee instability after they tear their ACL. The knee may feel unstable early after the ACL injury, or in some cases, patients will feel instability if they attempt to return to sports.

Treatment Options

  • Non-Surgical Treatments: Rest, physical therapy, and bracing are typically not effective for children in view of their activity level and high risk of recurrent instability which tends to lead to meniscus and cartilage damage.  Importantly, the meniscus and cartilage is very important for kids since they have many years ahead of them and must preserve these important tissues for the knee to function well.
     

  • Surgical Options: There are multiple techniques that Dr. Marx performs for ACL reconstruction which are tailored to the child’s growth plates and developmental stage in order to allow for optimal recovery and long term knee health.  Dr. Marx uses specialized techniques for growing children to avoid the growth plates and minimize risks. 

 

Our team uses the latest techniques and technologies to ensure that the surgery is performed with precision, taking into account the unique anatomical and developmental needs of children.   

What to Expect After ACL Surgery

ACL reconstruction is done as an outpatient procedure, meaning that the patient goes home the same day, depending on the case. After ACL reconstruction, a brace is typically used for five days, and then only as needed for comfort. Patients can walk with crutches, weight-bearing as tolerated and stop using them when they can walk with a normal gait. Most patients can walk normally within one month of the ACL reconstruction. Post-operative care includes a customized rehabilitation and physical therapy plan to help young patients return to their activities safely. Patients initially work on range of motion and strengthening and then start light jogging around four months after surgery. Full return to sports usually occurs at six to twelve months after the procedure. The vast majority of patients are able to return to their previous level of activity in sports following ACL reconstruction.  

More About ACL Injuries, Surgery, and Recovery

Dr. Marx is a participating physician in the Multicenter Orthopaedic Outcomes Network (MOON) Knee Group. MOON is a research group of ACL specialists and institutions dedicated to researching ACL injuries and improving treatment outcomes. MOON offers a wealth of information about ACL injuries, surgery, and rehabilitation here. 

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