Until a child’s bones have fully matured (in girls, typically by age 14; in boys, age 16), an injury to the anterior cruciate ligament (ACL) – the primary, stabilizing ligament of the knee joint – requires special consideration, treatment and care to ensure appropriate healing and to prevent long-tern complications.
According to a review articles in the February 2013 issue issue of the Journal of the American Academy of Orthopaedic Surgeons, ACL injuries once were considered rare in children and adolescents. However, the number of ACL injuries in young athletes is on the rise, “whether they result from year-found training, less free play or increased single sport concentration,” said study author and pediatric orthopaedic surgeon Jeremy Frank, MD.
To avoid potential future complications, such as early onset osteoarthritis, the literature review outlines the optimal strategies for treating pediatric ACL injuries based on the specifics of the injury and the child’s bone, age and developmental maturity. One recommendation includes postoperative management including weight-bearing and activity modifications, bracing, and a progressive physical therapy program emphasizing range of motion, closed-chain strengthening (exercises on the knee while the foot remains stationary) and a gradual and measured return to sport-specific maneuvers and activities.
“There are currently numerous safe and effective surgical techniques to reconstruct the ACL in the skeletally immature sportsperson to restore stability and forestall the early progression towards meniscal and cartilage disease,” said Dr. Frank. Complications from ACL surgery are rare in children when the appropriate operation is performed and the right patient.