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Tracy asked...

My son is waiting for an operation to reconstruct his acl and cartilage in his knee.

Hi my 13 year old son is waiting for an operation to reconstruct his acl and cartilage in his knee. After waiting for 4 months of drs telling me it was only a sprain/nothing serious he has had an mri and seen a second consultant who apparently is better at drilling into his bones and threading his hamstring through it but only in 6 months so a total of 11 months my son will have to wait for this to be fixed. This is effecting everything in his life he is completely stressed, scared and worried about his future! we are now being told he may not be able to take his gcse in p.e. because he is going to be unavailable to do the practical side while he recuperates for 9 months. I have tried to find help with, exercising which he still wants to do but cant seem to find any. I also would like to know if things could be made worse because of the time he has had to wait.

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The answer

Although injury to the important stabilising cruciate ligaments and cartilages of the knee are less common in children and young teenagers it is possible particularly if there has been significant force applied to the knee eg. a rugby or football tackle or heavy twisting injury such as occurs in skiing and snowboarding. If a knee joint becomes significantly swollen almost immediately after the injury as opposed to hours or a day later then you should always be suspicious of damage to the cruciate ligaments, bone or shock absorbing cartilages.  It is better to deal with the injury as soon as possible as resulting instability of the knee causes the bony surfaces of the knee joint to wear although a period of a few months is unlikely to do any serious lasting damage provided he is careful. While waiting for reconstruction surgery it is essential that your son tries to maintain good strength of the thigh and hamstring muscles as this will provide some stability and protection from further damage to the joint. Non weight bearing exercises such as controlled sitting knee extensions and hamstring curls or cycling are better than weight full bearing activities such as running. I would certainly advise avoidance of any contact sports or those which involve twisting and turning of the knee at the present time as further damage to the knee joint cartilages and bony surfaces could easily occur.  It would be helpful to get instruction from a physiotherapist as to an appropriate exercise regime.

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