ACL tears in children and adolescents can be a devastating injury.  For a worried parent, these study findings are sobering.  It is simply impossible to get a youngster to practice the restrictions we need to impose on you when you tear your ACL.   For that reason, many children and adolescents with ACL tears will go on to have many instability episodes.  With each episode, as the knee gives way, there is a chance that the child will tear their meniscus cartilage or damage the shiny articular cartilage that coats the ends of the bones.  Both of those injuries can have a profound impact on your children going forward into adulthood.

Children with ACL tears treated with an early reconstruction were 91 times more likely to return to their pre-injury activity level.

Writes lead author, David E. Ramski, BS, BM, of the Georgetown University School of Medicine:

Our results suggest that patients are much more likely to return to sports at their previous level of athletic ability after early operative treatment as well as have fewer instances of instability” of the knee or meniscus tears,

via Early ACL Reconstruction Strongly Recommended For Young Athletes, Study Says | MomsTeam.

No parent wants to subject their child to surgery.  But those same parents don’t want to tell their child why they can’t run around and play either. Those very same parents do not want to look back in 20 years when their child’s knee is bothering them and second guess a decision they made decades ago.

For a more in depth discussion about the management of ACL injuries in children and adolescents please click here


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About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

13 comments on “Early ACL Reconstruction Strongly Recommended For Young Athletes

  • Hi Dr. Luks, I have a 12 year old daughter who has an ACL tear. She tore it 1 month ago playing club soccer. We’ve been seen by two Orthopedic Surgeons who do not recommend surgery. They want us to wait until her growth plates are fused. I’m confused, she has no pain, no swelling, and its been hard to keep her from running around. I am encouraged by your blog, but confused. What is your recommendation for talking to these Doctors who have a contrary view from yours…

    • Good question German…
      The scientific literature is pretty clear on this topic. An early reconstruction helps minimize the risks of developing secondary injuries to the cartilage and the menisci. These injuries put your daughter at risk for developing arthritic changes at a young age. Many docs aren’t comfortable reconstructing a 12 year old — Getting a 12 yr old to stop all activities is very challenging. Seek and you will find a sports doc comfortable with treating young children with ACL tears.

      Good Luck .

  • Hello dr.Howard j.lukes,i am inspired by research that u have done on the knee injuries i too have torn my acl ligament probably it would be great to seek your advice about treating my injury i am a football player and this injury occured me in the last mid year i consulted with a surgeon and he told me to have acl reconstruction and also told to have a hamstring exersise but it was not that much help by doing physiotherapy i could not feel my leg as that much my other knee i just want to reach you and get treated by you sir but first i wanna know what will be the total expenditure of the surgery and rehabilation as i am from India please let me know that how could i reach u i am in very much in need of your help i will be waiting for your reply sir your

    Yours faithfully
    Asif khan

  • Hi Dr.Howard,
    I tore my ACL while playing football/soccer. I was able to complete the game after I sustained the injury. I noticed my knee making clicking sounds while walking.A few hours later my knee swelled up considerably and now it’s difficult for me to walk, yet i have no or very minimal pain. Any help or recommendations? I am 17 years old and eager to return to football.

    • Are you sure your ACL is torn? Most people can not complete the game after a tear. People who tear a meniscus might be able to complete the game they were playing. At your age, you should take the swelling seriously and see a sports doc

      • Hi,
        Actually, my son, 14, tore his ACL in May, which we thought was just a sprain, because after a couple of weeks of therapy he was able to play and train for another month until he injured his meniscus. An MRI showed a complete tear of the ACL, partial tear of his MCL, and meniscus tear. How he could play is still a mystery to us. He had the ACL repair little over 2 months ago and recovery is going great. His growth plates were still open so they used an Achilles Tendon Cadaver graft. He started jogging 4 weeks post op and is doing strength training. What do you think about this type of ACL repair? What is your prediction of when he will be able to return to competitive soccer?

      • At his age the statistics and research show that he has a very high risk of reinjury (20-25% or higher). That is for two reasons… the first is because of the allograft and the second is because of his age. For that reason many of us wait a year or more before allowing someone as young as your son to return to competitive sports.

  • Please can you tell me Where in the body you would find loose fibrous connective tissue , is this ligaments

    • under the skin… and various other places. ligaments are organized, tightly bundled collagen

  • My daughters is 14 years old she has a partial tear on her ACL by playing softball she feel no pain but scared to give her all when playing we wheat to a orthopedic and he said she needs surgery but not urgent were so confuse on what to do what do you recommend? Thank you

    • I would be very cautious. If your daughter feels like her knee is unstable or she is not confident that her knee will perform then she should be re-evaluated. Young children with unstable knees are at high risk of developing secondary injuries to the meniscus or the cartilage on the ends of the bones.

      Good Luck

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