The news on ACL injuries is not good.
The latest research shows the common knee injuries are on the rise among young athletes. That may come as no surprise, given the growth and hyper intensity of organized youth sports.
On top of the increase, other research suggests kids need a lot longer to recover from ACL surgery than the current practice. The Mayo Clinic Sports Medicine Research Center this spring said evidence shows the body needs 2 years to recover fully from ACL reconstructive surgery.
That can pretty much wipe out a high school or college career.
“ACL tears are quite an epidemic,” said Dr. Derrick Eddy, a sports medicine physician at Akron Children’s Hospital. “More kids are participating in sports, so the risk of exposure is higher. More girls are playing, and the rate of ACL injuries is higher in girls.”
The ACL – anterior cruciate ligament – is the main ligament of the knee. It stabilizes the knee joint and can tear as a result of sudden stopping or cutting. The tear often sounds like a pop, followed by pain, swelling and loss of range of motion.
Should you seek immediate medical attention?
It depends. If it happens in a weekend game, obviously you won’t be able to see your child’s doctor right away. If your child can still walk and the pain and swelling aren’t terrible, you should be able to wait to see a doctor. Home first aid should include icing and wrapping the knee, along with keeping it elevated.
“But if your child is having trouble putting weight on the knee, it’s not a bad idea to go to the ER or urgent care,” Dr. Eddy said. “You might not get a diagnosis, but they can get your child on crutches and help with pain.”
How is an ACL tear diagnosed?
“Eighty percent of the time, I can diagnose an ACL tear based on what happened – the plant, the twist and the pop – and by the feel. My hands can tell me if the ACL is gone,” Dr. Eddy said. “We do an X-ray to check for possible fracture. We get an MRI to confirm my findings of a tear.”
Is surgery always necessary?
“A partial tear usually doesn’t need surgery, but that’s rare,” Dr. Eddy said. “The ACL either goes or it doesn’t.
“You can live your life without an ACL. But if you ever want to cut and move side to side, you have to have an ACL. Most patients I see are very young and they still want to play sports, so they want to have surgery.”
What is the recovery time?
“It’s not a quick turnaround. It takes 6 to 8 weeks for the graft to adhere, and generally about 9 months before you can return to sports,” Dr. Eddy explained. “There is some data that if you go back before 12 months, there is a higher risk of re-tearing the ACL. Then there is the new data that says you should wait 2 years for the optimal outcome. In our society, that is not likely to happen.”
The Mayo Clinic study said strong evidence shows younger, more active athletes are at particularly high risk for a second ACL injury within 2 years of reconstructive surgery, and that waiting 2 years significantly reduces the incidence re-tearing.