ACL Reconstruction for Children

Pediatric ACL Surgery in Greater Detroit

ACL Reconstruction for Children in Royal Oak, MI - Christopher Minnock MDAnterior cruciate ligament (ACL) tears are a common injury in adolescent and even children of ages as young as 5-8 years old. These can occur in high-level national athletes and in the same way affect non-athletes. Almost all pediatric and adolescent patients benefit from reconstruction of the ACL to restore the ligaments critical function in stabilizing the knee. This protects the meniscus (shock-absorbing tissue in the knee) and the cartilage from injury. Both of these structures help prevent chronic pain and early knee arthritis over the long term. ACL reconstruction surgery takes tissue from elsewhere during the surgery to use as a graft to reconstruction the ACL. This is typically either a patient’s quadriceps tendon or bone-patellar tendon-bone tissue for patients that are done growing.  This type of graft that comes from the patient’s own body is called autograft. Graft tissue that comes from a cadaver that has been sterilized is called allograft. Allograft tissue has a very high rate of repeat tearing in young patients, so its use is very limited in adolescent and pediatric patients. Over the past 5-7 years, research has shown that using hamstrings tendons as a graft has a higher failure rate than quadriceps tendon or bone-patellar tendon-bone graft, and hamstrings graft is not a great option for ACL reconstruction.

Each of the autograft types have their advantages and disadvantages depending on patient’s age, skeletal maturity and particular demands on their sports or activities. Dr. Minnock will discuss the pros and cons of each graft type as part of the surgical discussion. Dr. Minnock is trained in specialized ACL reconstruction that avoids damaging the growth plates for young children who are still growing. This type of specialized surgery may be needed, depending on how much growth the child has left. If patients are close to being finished growing, then quadriceps autograft placed across the growth plates in the original ACL position works very well with a low rate of injury to the growth plates. For adolescent patients that are done growing, bone-patellar tendon-bone autograft is also a great option. For patients with more than 3 years of growth remaining, the ACL graft is placed while avoiding the growth plates. Dr. Minnock is trained in techniques to avoid crossing the growth plates in children with more than 3 years of growth remaining. This treatment is different than. treatment for adult patients.

After surgery, patients follow a progression of exercises with a physical therapist and work on these at home regularly during the recovery process. This allows patients to rebuild and to rebalance the muscles that stabilize the knee. Most patients are able to get back to running at 4 months, sports-type drills at 6 months, and are released to full sports without restrictions around 8-9 months after surgery once they have rebalanced these muscles with rehab exercises and depending on the specific sports requirements. There is no firm time period for recovery, and each patient has different needs depending on their specific sports and intensity of competition. Return to sport is determined by how strong, balanced and stable the muscles are around the knee following rehabilitation. Pediatric and adolescent patients have a higher risk of recurrent injuries than adult patients. Dr. Minnock will work with your physical therapist to ensure that you are progressing and have recovered enough strength and stability to get back to sports while minimizing the risk of recurrent injury.

Pre-surgery therapy exercises for at home