My child or teenager has torn their ACL. What is different for young patients?

Why young patients are different

The growth plates are areas of cartilage near the ends of the thigh and shin bones where growth happens. Standard ACL reconstruction involves drilling tunnels through the bone near these areas. In a child with a lot of growth remaining, this needs extra care to avoid uneven growth or a difference in leg length.

In children, a ligament injury can also pull off a piece of bone rather than tearing the ligament itself. This is called a tibial spine fracture and is treated differently.

Why simply waiting is often not the answer

Young athletes rarely stay away from running and jumping for years. A child whose knee keeps giving way at school sports or football academy training is at real risk of tearing the meniscus or damaging cartilage while waiting to finish growing.

For some children with partial tears or low activity, a period of rehabilitation and activity changes with close monitoring is reasonable. The decision is made case by case.

How treatment is tailored

• Skeletal age is estimated from X-rays, not just birthdays
• Techniques that avoid or minimise crossing the growth plates are used when much growth remains
• Teenagers near the end of growth can usually have an adult-style reconstruction
• Rehabilitation is longer and more supervised, with a cautious return to sport
• Follow-up continues until growth is complete, to check leg length and alignment

What parents in Qatar can do

Keep your child out of pivoting sport until the knee is assessed, and bring any X-rays and MRI images to the appointment. Let the school or academy coach know about the injury.

At Aman Hospital, Dr. Gelber examines the knee, reviews the growth plates and explains the options to the child and family together, including when a referral for specialist paediatric input is wise.