Once considered an adult injury, ACL tears are occurring more often in the legs of elementary and middle school-age children, orthopedic specialists report. The increase, which stems in part from better diagnostic tools and a dramatic increase in children playing competitive, organized sports, has created a vexing problem: What is the best way to fix it? Sports medicine experts are looking closely at the uptick in pediatric knee injuries, notably ACL tears.
For years, doctors have advised delaying surgery until the bones are finished growing, usually around age 14 for girls and 16 for boys. In the meantime, children were prescribed physical therapy and encouraged to remain active while using a knee brace, with the exception of cutting, pivoting and contact sports.
But postponing surgery hasn’t worked very well, in part because it’s difficult to keep children from further damaging the knee while they wait, In some cases for years. Athletic youngsters often must stop playing sports they love, a loss that can lead to depression and affect a child’s identity and friendships.
The anterior cruciate ligament, or ACL, which connects the thigh bones and shinbones inside the knee joint, is a crucial stabilizer during sports like basketball, football, soccer and lacrosse. Its job is to protect the knee from shifting, rotating and hyperextending as an athlete runs, jumps or lands. An easy way to tear the ligament involves simultaneously decelerating and twisting.
In adults, surgery is not always necessary, especially for those with sedentary lifestyles. Though skiing and soccer might be out, it is possible to walk, run and even play tennis with a fully torn ACL.
Risks are higher for children because it is hard to get them to modify their activity. A study published last year in The American Journal of Sports Medicine found that young athletes who delay surgery five months or more have a higher chance of suffering a secondary knee injury. Waiting can lead to progressive damage to other parts of the knee, including the meniscus and cartilage, multiple studies show.
Though official statistics are scarce, orthopedic specialists estimate that thousands of children and teens are tearing their ACLs each year. Researchers at Children’s Hospital of Philadelphia found a 400 percent increase in youth ACL injuries over the last decade, according to findings presented at the American Academy of Pediatrics 2011 annual meeting. Girls have up to eight times the risk of an ACL tear as boys; though no one knows exactly why.
Dr. Stickney in an expert in sports medicine who specializes in hip, knee and shoulder surgery at his Kirkland and Redmond locations. If you are experiencing knee issues or have questions about treatment options, contact our office to schedule your next appointment! Watch Dr. Stickney’s video and learn more about orthopedic surgery.