“Children are often referred to me by my fellow knee surgeons because this new ACL procedure has proved so successful.”
Professor Adrian Wilson

Children’s Knee Clinic

Children’s Knee Clinic is a specialist unit within Bupa Cromwell Hospital dedicated solely to the diagnosis and management of children’s knee problems, with particular expertise in knee ligament injuries.

As children become more involved in extreme sports such as skiing and snowboarding and are generally more active at a younger age, there is an increasing number of cases of ligament damage, particularly to the anterior cruciate ligament (ACL). As children’s bones and ligaments are not yet fully developed, they are at greater risk of damage.

Children’s Knee Clinic specialises in this complex area of surgery and offers a truly unique service in this field. The unit is headed up by Professor Adrian Wilson, who is joined by Consultant Orthopaedic Surgeon Mr Raghbir Khakha. They are supported by Mr Ben Wilde, a specialist physiotherapist, who has spearheaded the design of both a preventative warm up protocol and post-operative rehabilitation programme for patients.

Ligament problems in children and young people

Damage to the anterior cruciate ligament (ACL) is the most frequently seen injury in children and young people and is accelerating rapidly year on year, for a variety of reasons.

The ACL is the largest ligament in the knee and controls the back and forth motion of the knee, along with the less commonly injured posterior cruciate ligament (PCL), which helps give stability.

If the ACL is torn or ruptured, the knee becomes unstable when it is twisted and can give way, as well as losing its full range of movement. As the knee gives way, the delicate structures inside it, as well as the joint surface and meniscal cartilages, may also be damaged.

The Children’s Knee Clinic team has pioneered a number of new procedures for treating ACL injuries in children and, in some cases, it may now be possible to re-attach the torn ligament using keyhole surgery. Traditionally, ACL surgery meant a recovery time of up to a year, whereas these new procedures have reduced this to around four months. New techniques also minimise the risk of growth disturbance which is a major concern when operating on young children.

Ligament repair and reconstruction is usually easier to do in the first 6 – 8 weeks following an injury, although in some cases repairs have been carried out up to 10 years later.

It is widely recognised that up to 95% of ACL and PCL tears in young children are repairable. A neglected ACL or PCL injury results in altered biomechanics of the knee and an increased risk of secondary arthrosis in the long term.

Child ligament repair

Professor Wilson and his team have unique experience in children’s knee problems, having introduced new procedures for treating anterior cruciate ligament (ACL) injuries.

The ligament repair procedure which Adrian and his team have pioneered is much less invasive for the younger patient than ligament reconstruction as it allows them to keep as much of their own tissue as possible. This facilitates quicker healing and means they can return to activities and sports much quicker, typically around 14 weeks.

Children's Knee Clinic’s ASK warm up protocol

Children’s Knee Clinic is dedicated to injury prevention as much as offering a unique solution to their occurrence.

Children’s Knee Clinic has developed the ASK warm up protocol to introduce a clear direction for teachers, parents and sports coaches to help our young people avoid injury. ASK stands for, Activation, Strength & Kinetics. If you don’t know the best way to warm up then ASK!

The combination of exercises in the ASK protocol will play a significant role in reducing the number of non-traumatic knee ligament injuries in the young. The protocol is based on the FIFA 11+ and AIS netball warm up programmes, both of which have reported improvements of up to 40% reduction in the incidence of these injuries occurring following their implementation.

Mr Raghbir Khakha introduces the Children’s Knee Clinic

Professor Wilson with 13-year-old Dylan

Professor Wilson with 13-year-old Dylan


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    Read the abstract from our landmark paper on ACL repair in children. This innovative technique is less invasive than traditional surgery and children are able to get back to sport within 3 to 4 months, much quicker than with ACL reconstruction.