Mr Pydisetty provides comprehensive Paediatric Soft Tissue Knee service including Sports knee injuries at Alder Hey Children’s Hospital

Traditionally, ligament injuries in children have been reconstructed using a graft of their own. There has been an understandable reluctance in the orthopaedic community to undertake such an extensive operation on the developing knee of a child.

The return to activity and sport can take as long as 10-12 months following traditional reconstructive surgery. For young sportsmen and women, who may already be playing sport at an elite level when their injury occurs, this has potential life or career-changing impact.

Ravi has expertise in carrying out ACL repair in children. Traditional ACL surgery meant a recovery time of up to a year.

If an adult is injured and damages their anterior cruciate ligament, the tear (rupture) usually occurs in the upper or middle part of the ligament. However, in children and young people, the attachment of the ligament to the bone is a weak point and the ligament can be completely separated from the bone, possibly with a fragment of bone still attached.

In some cases, it may be possible to re-attach the bone fragment along with the ligament using keyhole surgery. However, ligament re-attachment can only be carried out in the first few weeks after an injury. In some cases anterolateral ligament (ALL) reconstruction alongside ACL surgery to improve the outcome.

After surgery, your child will need to walk with the assistance of crutches initially, limit physical activity and wear a full-leg brace for 4 to 6 weeks. Painkillers and anti-inflammatories are prescribed initially to ensure they remain pain free.

Recovery from ACL surgery can take upto 6-9 months. Physiotherapy is a big part of this to restore the range of motion, regain strength and stability and reduce swelling.

Getting back to sport is a definite possibility

More usually, we recommend children get back to more gentle activity such as swimming, cycling before progressing to running. Contact sports may remain off limits for a number of years, however we always review patients regularly and advise on activities which can be safely enjoyed.