Anterior cruciate ligament (ACL) injuries in children and teenagers are less common than in adults. But they do occur, especially in teenagers. An injury that hasn't been treated (or one in which the treatment didn't work) can lead to future knee problems. The knee may become more and more unstable. Over time, osteoarthritis may develop.
Trying rehab and other treatments
A child with an ACL injury can sometimes be treated without surgery to avoid damage to the child's still-developing bones. Your child can try rehab exercises, wearing a brace, and avoiding activities that require jumping or twisting.
Surgery is usually recommended for active children, to keep the knee more stable and to help prevent future problems.
An avulsion fracture is more common in young children. This happens when the ligament and a piece of bone separate from the rest of the bone. It can often be treated with a cast. But it sometimes needs surgery.
You may consider surgery if:
The knee is very unstable doing simple daily activities.
The child is a serious athlete in sports that require running, jumping, and stopping quickly.
The particular risk of surgery in a child whose bones are still growing is slowed growth. This could make one leg longer than the other. Other risks include a deformed thigh bone. The closer a child or teenager is to full growth, the lower the risk of these problems.
Rest after surgery and a long rehab program are very important.
American Academy of Orthopaedic Surgeons (2014). Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline. Rosemont, IL: American Academy of Orthopaedic Surgeons. http://www.aaos.org/research/guidelines/ACLGuidelineFINAL.pdf. Accessed June 12, 2015.
Ramski DE, et al. (2014). Anterior cruciate ligament tears in children and adolescents: A meta-analysis of nonoperative versus operative treatment. American Journal of Sports Medicine, 42(11): 2769-2776. DOI: 10.1177/03635413510889. Accessed June 19, 2015.
ByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Brian O'Brien, MD, FRCPC - Internal Medicine E. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerFreddie H. Fu, MD - Orthopedics