Anterior cruciate ligament (ACL) injuries are often associated with professional athletes, but there is a less visible phenomenon that affects children and adolescents, even at a very young age. This issue was discussed in La Gazzetta dello Sport by the Director of our Education and Research Department, Dr. Francesco Della Villa.
In recent decades, there has been a marked increase in anterior cruciate ligament injuries within the pediatric population, with cases reported as early as 10–11 years of age. International studies show a steady annual increase of around 3%, a trend that has also been confirmed in Italy.
A study involving more than one thousand young Italian soccer players found a 3% risk of ACL injury per season, rising to as high as 10% in girls over a two-year period—an especially alarming figure.
This trend is linked both to the increase in sports participation and to more accurate diagnostic methods, while the debate remains open regarding early sports specialization and insufficient basic physical conditioning.
Most of these injuries occur without contact, during movements such as deceleration, changes of direction, or landing, which generate high forces on the knee. The rupture of the anterior cruciate ligament is often associated with damage to the menisci and cartilage, leading to joint instability and a reduction in sports activity.
In young patients, the problem is compounded by the fact that the body is still growing, making specialized management and proper communication with families essential. Today, the decision to pursue surgical treatment is increasingly personalized and based on specific clinical criteria.
Recovery requires a long rehabilitation process, with particular attention to neuromuscular control and movement patterns, leading to a gradual return to sport.
Finally, prevention is both possible and effective: targeted exercise programs, when performed consistently, can drastically reduce the risk of injury—especially in young athletes—representing a concrete and crucial challenge for modern sports medicine.
