Sometimes it seems like children are made of rubber. They fall or they injure themselves in some way but they get up and bounce back as if nothing ever happened. But in reality, that’s not always the case. And with more children and teens participating in sports activities, there has been a rise in the number of musculoskeletal injuries in this age group.
One of those injuries is what your son experienced — a tear of the anterior cruciate ligament (ACL). The ACL is one of two ligaments that criss-cross inside the knee to give it stability. The ACL helps the knee bear the weight or load of our body while we move, twist, jump and turn.
A recent review of medical records for 371 pediatric patients who had surgery to reconstruct a torn ACL showed that being overweight is a risk factor for injury. And not just the primary (main) ACL injury, but also damage to the meniscus and chondral (cartilage) surface of the joint.
This type of study has been done in adults and found that the longer the patient waits between ACL injury and surgery, the greater the risk of meniscal and chondral damage. And that can mean damage that can’t be repaired and that leads to arthritis and loss of knee function in time. A study like this could potentially save children from the same fate. And this is the first study this large to really help answer some of these questions.
They found three factors that increase the risk of poor outcomes and degenerative changes in the knee. The first was a time delay between when the injury happened and when treatment was received. Children who had surgery in the first 150 days (five months) had fewer meniscal tears compared with children whose surgery took place later.
And as we already mentioned, obese children putting greater load on the damaged tissue were more likely to experience additional injury to the meniscus and chondral surface of the joint. In all children, the presence of a meniscal tear also increased the risk of further chondral damage. Pediatric patients older than 15 years had a higher rate of meniscal tears.
You are right to be concerned about your son’s excess weight. Obesity is becoming a major public health problem in all ages — including our youngsters. Exercise is essential in preventing early-onset of diabetes and later problems such as heart disease. Obese individuals (children and adults) are at increased risk for musculoskeletal injuries. Such physical injuries can have a lifelong impact.
When your son recovers from this episode, perhaps swimming, biking, or some other noncontact sport might be a helpful way to lose weight without serious injury.