Anterior cruciate ligament (ACL)

The ACL will not heal (regenerate) on its own, so standard treatment is reconstruction surgery. During ACL reconstruction surgery, the torn ACL is removed and replaced with a graft of tendon taken from the hamstring muscles or elsewhere.

Non-surgical treatment

If your child is still growing (skeletally immature), surgery isn’t recommended due to the potential harm to growth plates non-surgical treatments.

Non-surgical treatment can include bracing, physical therapy, limiting activity and other therapies until she’s fully grown, at which time ACL reconstructive surgery can be performed, if needed. Newer techniques that spare the growth plates can also be used in children who are not yet finished growing.

Surgery for an ACL tear

Surgery for an ACL injury is recommended if a child is experiencing knee instability or if the ACL is completely torn. Current techniques involve reconstructing the ACL by creating a new ligament out of tissue harvested from one of the other tendons around the knee (autograft), or from a cadaver (allograft).

Up to 90 percent of patients can return to sports and normal activities without symptoms of knee instability. After your child’s knee has healed, and after her strength and stability have returned through intensive physical therapy, she should be able to return to her previous sports and activities.

Prevention

Can an ACL tears in children be prevented?

A torn ACL is not strictly a preventable injury, since sports such as basketball, soccer, skiing, gymnastics, volleyball and football do put athletes at some risk to tear their ACLs. But athletes and active young people can reduce their risk by:

• maintaining general health and fitness: sport-specific conditioning, diet, exercise, sleep
• learning/using proper sport-specific movements (form) and techniques
• wearing/using proper sport-specific gear
• learning which moves cause risks (risk awareness)
• hamstring/leg strengthening (especially for girls)