Pediatric Sports Medicine Specialist Studies New Technique for ACL Surgery in Young Athletes

Children and teens have a lot of energy, especially when they are playing a sport they enjoy, but sometimes all that energy and passion for the game can cause serious injuries. Many players would rather stay in the game – or finish up a season – than listen to their bodies and rest an injured knee or ankle.

Most childhood and adolescent sports injuries are sprains and muscle pulls – the kinds of injuries that will generally heal themselves with proper rest. “Unfortunately, many kids are under a lot of pressure – sometimes from themselves – to return to the game or practice field before they are ready,” said Kunal Kalra, M.D., an orthopaedic sports medicine specialist at the Children’s Hospital of Michigan. As a result, a minor injury can become a more serious and long-lasting injury.

Child playing with toy

Other times, pediatric sports injuries can be serious from the start – as is the case with a tear in the anterior cruciate ligament (ACL). Without ACL treatment, these knee injuries can cause damage to the cartilage and menisci – eventually leading to osteoarthritis. Surgical treatment of ACL damage is often performed on adult athletes, but surgical treatment is problematic with children as it requires the surgeon to drill a hole through the child’s growth plate.

“We know we need to avoid damaging the growth plate so the child will continue to grow and thrive as he or she matures,” Dr. Kalra said. “This new procedure has been described in the medical literature, but it has never been studied in detail.”

That’s why Dr. Kalra and his colleagues at the Children’s Hospital of Michigan are conducting a laboratory test of two different types of ACL repair – one using the standard technique which requires drilling through the growth plate and the other using an alternative surgical treatment that avoids the growth plate. Using donated cadaver knees, Dr. Kalra hopes to show that it’s possible to repair an ACL injury without damaging the growth plate.

“We are doing a biomechanical study where we are testing these different techniques for reconstructing or repairing the ACL to avoid the growth plate and we compare with the conventional technique to see if one technique is better than the other,” Kalra said. “We’d like to see that the special technique we use in kids is at least as good as the one we typically perform in adults.”

The research is funded by the Children’s Hospital of Michigan Sports Medicine Research Foundation. In total, Dr. Kalra and his colleagues will perform the procedure on 18 cadaveric knees. “We are through the first phase, but have many more knees to study.”