Anterior cruciate ligament (ACL)

If your child has been diagnosed with an ACL tear, we know that you and your family are under stress. So, at Children’s Hospital Boston, we’ll approach your child’s treatment and rehabilitation with sensitivity and support—for your child and your whole family. And it will be our constant goal to get your child back to normal life, and back into the game.

About the ACL and ACL injury

The anterior cruciate ligament (ACL) is one of four main ligaments in the knee. Its job is to provide stability to the knee and minimize stress across the knee joint.

• The ACL is the most commonly injured knee ligament, affecting 400,000 Americans each year.
• Tears can occur when the ACL is overstretched.
• Injuries usually occur while an athlete is playing sports that involve cutting and pivoting, like soccer, skiing, basketball, gymnastics, volleyball and football.
• Because teens are the most athletically active demographic group, their knees are continually at risk; 10 to 15 percent of teens who've torn an ACL will tear an ACL again.
• Girls are five to eight times more likely than boys to tear their ACLs.
• The ACL will not heal (regenerate) on its own, so standard treatment is reconstruction surgery—removal of the torn ACL and replacement with a graft of tendon taken from the hamstring muscles or elsewhere.
• The majority of patient who undergo ACL reconstructive surgery can return to sports within six to nine months of surgery.

The Children’s Hospital Boston approach to ACL injury

You can have peace of mind knowing that the team in Children’s Orthopedic Center has treated thousands of children, adolescents, adults and professional athletes with this serious but highly treatable injury to the knee.

Some of the world’s most advanced research into ACL anatomy and treatment is coming from Children’s researchers. So, we can provide your child with expert diagnosis, treatment and care—as well as the benefits of some of the best ACL clinical and scientific research in the world.

• Researchers at Children’s Sports Medicine Research Laboratory, led by Martha Murray, MD, are developing a new procedure to stimulate the healing of a patient’s own ACL, with the goals of restoring the knee’s normal biomechanics and preventing premature arthritis.

Fig. 1              Fig. 2              Fig. 3              Fig. 4

            Fig. 1 ACL is torn
            Fig. 2 Healing does not occur when blood clot dissolves in joint fluid
            Fig. 3 Collagen and blood plasma mixture is injected
            Fig. 4 ACL heals successfully

• Children’s Lyle Micheli, MD, director of the  Division of Sports Medicine, has created a series of innovative, age-specific physeal sparing reconstruction techniques—alternatives to traditional surgery for younger children whose growth plates are still open.
• Children’s Orthopedic Center provides comprehensive assessment, treatment and follow-up care to children, adolescents and young adults who have sports-related orthopedic injuries. Our skilled orthopedic surgeons and sports medicine physicians work with physical therapy staff to develop long-term treatment and activity plans. Our team has also developed innovative evaluation programs and effective  injury prevention strategies.

ACL injury: Reviewed by Martha Murray, MD
© Children’s Hospital Boston, 2010