An anterior cruciate ligament (ACL) sprain is a tear of one of the four major ligaments of the knee. The ACL is a ropelike structure in the center of the knee that helps maintain the normal relationship of the femur (thigh bone) and the tibia (leg bone). When torn, the ACL does not heal and the knee can be unstable (shifts or gives way) during sports that require pivoting, changing direction (cutting), jumping, or landing. About half the people who tear their ACL also tear their meniscus in their knee. ACL tears in pediatric patients pose an extra challenge in that typical surgeries to reconstruct the ACL can injure the open growth plates around the knee and affect normal growth.

The diagnosis of an ACL tear is usually made on physical examination, but MRI can be helpful, especially when the patient is too swollen or guarded to allow a thorough examination. The MRI also is needed to diagnose any associated meniscal or cartilage damage.

The ACL will not heal on its own, but most people can perform normal daily activities after an appropriate rehabilitation program. For young patients and those who want to return to sports, surgery is recommended. If left untreated, the patient is at risk for further injury to their meniscus and cartilage, due to knee instability. Younger patients also are at risk for early arthritis if the ACL is left unrepaired. Surgery to reconstruct the ACL while avoiding injury to the growth plate can result in a stable knee, prevent early progressive damage to the meniscus and cartilage and allow return to full activities. Dr. Chudik developed a special technique to reconstruct ACL’s in young patients to avoid injury to their open growth plates.

ACL injuries are increasing in young athletes This report by Dr. Steven Chudik examines the injury, and various treatments options.