ACL tears in children: A comprehensive guide for parents

Written in association with: Mr Shobhit Verma
Published: | Updated: 23/07/2024
Edited by: Carlota Pano

Due to differences in bone development compared to adults, ACL tears in children require specialised care and consideration in both diagnosis and treatment to ensure optimal recovery and the health of the knee joint.

 

Mr Shobhit Verma, renowned consultant paediatric orthopaedic surgeon, provides an expert guide to paediatric ACL tears, offering insights into their causes, signs, and current treatment options.

 

 

What is the ACL?

 

The anterior cruciate ligament (ACL) is a band of connective tissue within the knee which is responsible for stabilising the joint, minimising stress, and preventing the knee from rotating or slipping out of place during activities like jumping, running, and landing. The ACL is susceptible to tears during sports and exercise, often due to non-contact twisting injuries, and this has become a common injury among children.

 

What are the signs of an ACL tear?

 

Symptoms of an ACL tear may include:

  • hearing a popping noise at the moment of injury
  • increased pain when attempting to bear weight on the affected leg
  • swelling
  • a feeling of instability or the knee giving way during weight-bearing activities

 

What treatment options are available for paediatric ACL tears?

 

Treatment for paediatric ACL tears typically involves surgery, as conservative methods like bracing and strengthening exercises have generally shown limited effectiveness.

 

Surgical intervention, particularly reconstruction, presents specific challenges. In children, who are considered skeletally immature due to their growing bones, the ends of each bone have an area called the epiphysis or growth plate which are the weakest part of the knee.

 

Traditional ACL tear repair involves drilling tunnels in the thigh and shin bones at the knee joint to replace the damaged ACL with graft tissue. However, since the growth plate lies in the path of these drill holes, traditional ACL reconstruction can lead to growth abnormalities in the child, such as uneven leg lengths. The younger the child, the higher the risk of significant deformity.

 

Are there alternatives?

 

Alternative surgical techniques have been developed to minimise the risk of growth arrest. One approach involves drilling holes that bypass the growth centres rather than passing through them. Another procedure avoids drilling holes altogether and wrapping the graft around the bones instead.

 

To reduce the likelihood of ACL tears, it's important to utilise appropriate protective gear and use correct techniques during sport activities or exercise.

 

 

To schedule an appointment with Mr Shobhit Verma, head on over to his Top Doctors profile today.

By Mr Shobhit Verma
Paediatric orthopaedics

Mr Shobhit Verma is a highly respected consultant paediatric orthopaedic surgeon based in London, Bedfordshire and Hertfordshire. He is renowned for his expertise in foot and ankle problems, paediatric hip and walking disorders. He additionally specialises in bowed legs, deformity and hip dysplasia.

Mr Verma qualified in medicine from Veer Narmad South Gujarat University, India in 1995 before completing a Master of surgery (MS) specialising in orthopaedics. He then went on to undertake a series of highly esteemed fellowships, including several accredited by the Royal Australasian College of Surgeons (RACS). In this period, he completed a paediatric and adult trauma and arthroplasty fellowship at Flinders University and Medical Centre in Adelaide and was also a senior clinical fellow in trauma surgery at The Alfred Hospital in Melbourne. In 2013, Mr Verma was appointed as a fellow of the European Board of Trauma and Orthopaedics and the following year, also achieved fellowship of the trauma and orthopaedics section of the Royal College of Surgeons of Edinburgh. He was additionally awarded a senior fellowship specialising in paediatric orthopaedics at Birmingham Women’s and Children’s NHS Foundation Trust. Since 2016, Mr Verma has served as a consultant paediatric orthopaedic surgeon at King’s College London, Bedfordshire Hospitals and London and Dunstable Hospital NHS Foundation Trusts, and is clinical lead in orthopaedic surgery at the latter. He sees patients in private practice at a number of locations in London, Bedfordshire and Hertfordshire; The Cobham Clinic, The Clementine Churchill Hospital, One Hatfield Hospital, The Bridges Clinic and Spire London East Hospital.

Mr Verma has extensive teaching experience and has regularly trained junior doctors and medical students in Australia, India and the UK throughout his career. He currently serves as an invited faculty member of various FRCS courses in London and frequently teaches medical trainees from University College London and King's College London.

Additional to his clinical and teaching responsibilities, Mr Verma remains actively involved in research and has acted as principal investigator in various studies. He has also produced a number of academic papers which appear in peer reviewed journals and regularly presents at key conferences. Mr Verma is a member of the European Paediatric Orthopaedic Society and the Indian Medical Association.

View Profile

Overall assessment of their patients


  • Related procedures
  • Congenital malformations
    Abnormal gait
    Elbow
    Elbow Pain
    Fractured elbow
    Shoulder dislocation
    Fractured shoulder
    Meniscus
    Chondromalacia (runner's knee)
    Medial collateral ligament
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.