» Should Children be 14 Before ACL Surgery?

Should Children be 14 Before ACL Surgery?

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When to do surgery on an anterior cruciate ligament (ACL) tear varies from patient to patient (of any age) and even from surgeon to surgeon. Surgeons often delay surgery of this type in children until the growth plates have sealed up and the bone is fully mature.

Some surgeons follow the guideline of waiting until the child is at least 14 years old and/or reached skeletal maturity before reconstructive surgery is done. Studies show that this idea is probably a good one. Anything that can damage the growth plates increases the risk of growth delays and/or leg length differences. Fortunately, the delay does not seem to enhance the risk of meniscal and/or cartilage lesions.

That's not always true for adults who for every month that goes by without surgery after an ACL tear, the risk of a cartilage lesion increases by one per cent. Meniscal tears are much more common in adults who have reconstructive surgery late (12 months or more after the injury) compared to those who had the operation within the first year. This relationship is true for adults but not for children.

For now, children who have not completed growing are given the option of a rehab program to help them get back into daily activities and especially sports participation for those who are athletes. Activity modification and a knee brace may be advised. It depends on the type of activities you engage in and the level of demand placed on the knee.

Reference: Lars-Petter Granan, MD, et al. Timing of Anterior Cruciate Ligament Reconstructive Surgery and Risk of Cartilage Lesions and Meniscal Tears. In The American Journal of Sports Medicine. May 2009. Vol. 37. No. 2. Pp. 955-962.

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