How is an ACL injury treated?
Although non-surgical treatment – such as knee-bracing and physical therapy – is an option, it is generally not the treatment of choice for young people. Young people who choose not to undergo surgical reconstruction tend to experience continued episodes of their knee "giving out" and long-term knee problems.
In general, doctors at Children's Hospital Colorado recommend a knee operation to make a new ACL out of another tendon. There are several different choices for the new ACL, which your child's surgeon will discuss with you.
What is ACL surgery?
The goal of ACL surgery is to return the knee to normal function and stability. During ACL surgery, an orthopedic surgeon will create a new ligament from your child's own tissue (called a graft) to reconstruct your child's ACL. Our pediatric specialists will use both local and general anesthesia to keep your child comfortable during the procedure.
Your child will likely be cleared to return home a few hours after the ACL procedure. They will need to be on crutches for two to six weeks after surgery until they gain muscle control and are able to walk without pain in the brace. Your child's physical therapist or physician will let you know when they are ready to walk without the brace and crutches.
Physical therapy (PT) is an important component of your child's recovery before returning to sports. PT should start four to five days after surgery and will last at least 9 to twelve months. Learn more about ACL injury rehabilitation.
Your child's care team will also work with you to schedule a series of follow-up appointments after surgery.
What are the different graft options for ACL surgery?
Our sports medicine specialists use tissue from your child's own body to reconstruct their ACL. This is called an autograft, which research shows adapts more quickly, predictably and with a much higher rate of success compared to alternatives.
The two most common autograft options use either two of the hamstring tendons or a part of the patella (a fancy word for knee) tendon. At Children's Colorado, we also offer a third option, called the quadriceps tendon autograft (also called the quad-tendon graft for short). Learn more about the different ACL graft options.
Is ACL surgery different for children and teens?
An important consideration for ACL surgery in children and adolescents is that their bones are still growing. Bone growth comes from the growth plates, which are at the ends of the bones and increase the length of the bone.
Traditional ACL surgery puts these structures at risk for causing a limb length discrepancy or a deformity. At Children's Colorado, we specialize in surgical techniques to minimize this risk and maximize a young athlete's return to competitive sports and recreation.
What is the recovery process after ACL surgery?
To complete ACL rehabilitation thoroughly and safely, our sports medicine experts use a 9 to 12 month average timeframe for returning an athlete to sport. However, this process and timing will vary for each athlete.
If you break our rehabilitation approach down to a simple process, the physical components of ACL recovery and preparation for return to sport are:
- Get rid of the swelling in the injured knee
- Get the motion back in the joint
- Make the quadriceps work again
- Walk normally
- Recover the strength in the entire leg to be comparable with the other leg
- Re-train balance, agility, symmetry of movement and the ability to move with explosive, quick patterns
- Recover foot speed and every other skill your particular sport requires
See a full summary of our ACL rehabilitation timeline to learn more about the recovery process.