YOUR HEALTH: Why a child’s torn ACL needs to be treated differently

HOLLYWOOD, California – A torn ACL is the most common knee injury but it can have your little athlete sitting on the sidelines for most of a season.

ACL tears normally require surgery and the rate of injury has skyrocketed by nearly 400% in adolescents over the past 15 years.

"I like to play soccer, basketball, I like to run a lot."

Like most eleven year olds, Matthew Lefkowitz is super active, until the day he tore his ACL playing soccer.

"It was really painful, I was crying a lot."

In most cases, doctors recommend surgery to reconstruct the ligament that provides crucial stability to the knee.

But when it comes to children, it's important to protect their growth plates.

"So you don't injure them, causing one leg to be longer than the other, or even grow at an abnormal angle," explained Dr. Jeremy Frank, Pediatric Sports Medicine Surgeon at Joe DiMaggio Children's Hospital.

That's why Dr. Frank is using a specialized technique to rebuild a child's ACL.

"We're taking a strip of tissue from the side of the thigh, that tissue is called the iliotibial band, or IT band," said Dr. Frank.

The surgeon then wraps that tissue around the thighbone, through the knee, and stitches it into the top of the shin bone.

"Therefore we're not drilling any holes whatsoever in the bones, and not risking any injury to the growth plate."

IT BAND:  If a child is young, surgeons will use a technique that spares the growth plate.  One example is iliotibial (IT) band reconstruction. The IT band is a thick band of tissue that spans the leg from the lower pelvis to the bottom of the shinbone. Tightening this tissue over the kneecap helps to stabilize the knee and prevent the tibia from moving too far forward.  After surgery, a child will need to walk with the assistance of crutches, limit physical activity, and wear a full-leg brace for 4 to 6 weeks, depending on what the surgeon advises.

Of course, Matthew's mom was still worried when her son went in for surgery.

"Would he come out and be able to play and run the same way he always did?" asked Nina Lefkowitz.

A year later, Matthew is back on the field!

"I recently just got cleared by Dr. Frank that I don't need any brace anymore to play sports."

He wants other kids not to be scared if they need ACL surgery.

"I feel great, I feel like it never happened."

Getting kids back to the sport they love.

TREATMENT:   Treatment for ACL tears depends on the age of the athlete and the sports that the athlete plays.   Conservative treatment includes activity modification, rehabilitation exercises, and bracing during activity.   Surgical treatment involves creating a new ligament from a tendon in the patient's knee or from a tissue donor.   Surgery is ideally done after the athlete has recovered from the effects of the initial injury.   If the knee is still swollen, stiff, or weak at the time of surgery, any benefits from early surgical treatment will be lost by delays in surgical recovery.   Young athletes may choose to hold off on surgery until their bones are finished growing to reduce the risk of growth plate injury from the surgery.   New surgeries are being developed to avoid this.   Most athletes who participate in running, jumping, pivoting, or contact sports are likely to need surgery to continue playing their sports.   With proper surgical treatment, about 90% of athletes are able to return to their sports at approximately six months after surgery.

The recovery is still the same as any ACL procedure: physical therapy for up to five months and light activity like swimming or biking three months after surgery.

Most kids are back to their sport of choice within a year after the injury.

Dr. Frank says the re-rupture rate in children is between 5% and 10%.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.