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Torn between the Alternatives for Treating ACL Tears in Kids

Posted on: 10/22/2002
There is still some uncertainty as to the best treatment for a partially torn anterior cruciate ligament of the knee. The uncertainty generally prevails when this injury occurs in a child or adolescent. Because more and more kids are suffering this type of injury, doctors are faced with having to determine the best treament options despite the uncertainty.

This study looked at kids 17 and younger who had partial tears of the ACL. The doctors chose kids who had less severe ACL tears. The kids spent several weeks putting no weight on the knee and wearing a special knee brace. Then they went through several weeks of physical therapy. They were allowed to return to their activities after three months with a knee brace.

About one-third of the injured kids needed ACL surgery down the road. The doctors found that the kids who needed surgery were older, had the worst tears, and had tears in a certain part of the ACL. This trouble spot is along the back and outside edge of the ligament, called the posterolateral region. These doctors recommend that kids 14 and under with partial ACL tears and relatively stable knees be treated without surgery. They suggest surgery for kids 15 and older with larger tears or with tears in the trouble spot of the ACL.

References:
Mininder S. Kocher, MD, MPH, et al. Partial Tears of the Anterior Cruciate Ligament in Children and Adolescents. In The American Journal of Sports Medicine. September/October 2002. Vol. 30. No. 5. Pp. 697-702.

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