Knee · Ligaments
Pediatric ACL reconstruction
ACL Tear in a Growing Child or Teen — Growth Plate-Sparing Reconstruction
The condition
The ACL is a strong ligament in the center of the knee that keeps it stable when cutting and pivoting. Children and teens who are still growing have open growth plates near the knee. An ACL tear lets the knee give way, which can damage the meniscus and cartilage if not treated.
The surgery
This is a typically outpatient surgery done through small incisions with a camera. A tendon graft replaces the torn ACL, using a technique that avoids or limits crossing the growth plates (physeal-sparing), chosen for your child's age and growth remaining. A torn meniscus may also be repaired. The final plan is determined during surgery.
Recovery at a glance
- Weight-bearing
- Full weight, or touch-down for 4 weeks, depending on technique; a brace for 2–6 weeks. Most walk normally without crutches by 4–6 weeks.
- Motion
- Fully straight and bending to 90° by 2 weeks; bending to 120° by 6 weeks.
- School & play
- School often within 1–2 weeks; no PE, recess play, or sports until cleared. Growth is checked at follow-ups. No driving while taking narcotic pain medication.
- Running
- Not before 16 weeks, once strength and control allow.
- Sports
- No sooner than 9 months, after strength, hop, and movement testing; full return typically 9–12 months.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Most young athletes regain a stable knee and return to sports. Risks are uncommon and include infection, blood clots, a growth disturbance (leg-length or alignment difference), graft re-tear (young athletes have the highest re-injury rate), injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
Open, save or print. Bring your questions to your pre-op visit.
Before & after every surgery