ACL injuries are becoming more common in the paediatric and adolescent population. ACL injuries occur with twisting and bending incidents and girls are more at risk due to their different leg angles associated with a wider pelvis compared to boys.
Sports that are particularly at risk are: AFL, soccer, netball and lacrosse.
Repair of the ACL in kids is a bit more complicated than in adults due to their patent growth plates – if this gets damage it can alter the way the leg grows, causing more problems later on.
However, a delay in surgery can cause problems too, including increasing the risk of meniscal tears.
A study came out in the Journal of Bone and Joint Surgery in August 2001 investigating the impact of waiting for surgery on just this. They found that for each week surgery was delayed there was a 3% increase in having a meniscal tear for boys but not for girls. Interestingly, using crutches after the injury helped reduce the risk, and being an obese male increased the risk.
So what are the takeaways from this?
1. Be as fit as possible with sports specific training to help reduce the risk of getting injured in the first place.
2. If you are injured, seek help quickly to get an appropriate diagnosis and treatment plan. A good GP or physical therapist will be the best place to start.
3. If you do have an ACL tear, seek an orthopaedic review to find out if surgery is the right option for you. If the patient is a child or adolescent, make sure the surgeon has experience in doing ACL repairs whilst sparing the growth plate.
4. Doing Pre-hab with a good physical therapist will maximise your outcomes.
5. Use crutches and any braces prescribed while you wait for surgery to minimise the risk of doing more damage.
6. Doing rehab after the surgery will help you get back to the activities you love. Be guided by your medical team before returning to sport!