Pediatric ACL and knee ligament Surgeon in Salem, Oregon
Overview
ACL (anterior cruciate ligament) tears are increasingly common in pediatric and adolescent athletes due to early sports specialization and high-intensity competition. Dr. Daniel Elkin is a fellowship-trained orthopedic sports medicine surgeon who provides expert, growth-respecting ACL reconstruction techniques designed to protect the developing skeleton and restore stability in young athletes.
Dr. Elkin treats the entire knee, not just the ACL—carefully evaluating and addressing associated meniscus tears, cartilage injuries, and overall joint integrity to ensure a complete recovery and long-term joint health.
Signs and Symptoms of ACL Injury in Children
Recognizing an ACL tear early can improve outcomes and limit long-term damage. Common signs in pediatric patients include:
- A popping sound or sensation at the time of injury
- Immediate swelling of the knee (within hours)
- Pain and inability to continue playing
- Feeling of instability or “giving way” during activity
- Loss of full range of motion
- Favoring the opposite leg or limping
If your child experiences any of these symptoms after a sports-related knee injury, prompt evaluation is critical.
Why Pediatric ACL Tears Require Special Attention
Children and teens have open growth plates (physes) that can be harmed by adult-style ACL surgeries if not carefully managed. Left untreated, ACL tears can lead to repeated episodes of instability and secondary injuries—including irreparable meniscus tears and cartilage damage.
Early intervention is key. Prompt surgical treatment improves long-term outcomes and decreases the risk of additional joint damage.
Age-Specific ACL Reconstruction Techniques
1. Growth Plate–Sparing Techniques
For prepubescent and early adolescent athletes:
- Physeal-sparing and partial transphyseal reconstructions avoid or minimize crossing growth plates.
- Techniques include:
- All-epiphyseal reconstructions (no tunnels across physes)
- Hybrid techniques using soft tissue grafts with precise tunnel placement
2. Adult-Type Reconstruction for Teens nearing skeletal maturity
For older adolescents with closed or nearly closed growth plates:
- Anatomic ACL reconstruction is performed using adult-style techniques
- Most common in:
- Girls >13-14 years
- Boys >14-16 years
Comprehensive Knee Evaluation
ACL tears in children often occur alongside other knee injuries. Dr. Elkin performs a comprehensive arthroscopic assessment and treats:
- Meniscus tears – with repair techniques to preserve tissue and function
- Cartilage defects – including chondral and osteochondral injuries
- Ligament stability – full evaluation of knee biomechanics
Preserving meniscus and cartilage early in life is critical to preventing early arthritis and maintaining long-term knee health.
What to Expect
- Outpatient surgery with minimal incisions
- Graft options tailored to the patient’s age and anatomy
- Rehabilitation begins immediately post-op
Return to Activity: Return to full sporting participation can take some time after surgery. The current recommendation is that patients wait to return to twisting/cutting/pivoting sports for at least 9 months. This allows the ACL graft to mature and strengthen inside the knee, and for your muscular strength and endurance to improve. Patients will go through different phases in their rehab. The first goal is to minimize inflammation, promote healing, and regain mobility within the first month. We then have you regain strength and neuromuscular control of the knee. You then begin to incorporate running and impact around the 3-4 month mark. Finally, you will progress towards sports specific training and return to play between 6-12 months after surgery.
Revision ACL reconstruction: Dr. Elkin also specializes in revision ACL reconstruction procedures. A revision is sometimes indicated when an initial surgery fails or when a new injury occurs to a previously reconstructed knee.
ACL Surgery in Oregon
Dr. Daniel Elkin is a leading Orthopedic Surgeon performing ACL Surgery in the Willamette Valley. He specializes in complex knee reconstruction and knee arthroscopy and is conveniently located in Salem, Oregon.