One patient’s story: From torn ACL to MVP

For kids like 8-year-old Fletcher Gallimore, playing sports is part of their identity. But in September of 2011, Fletcher—who loves football and basketball—was accidentally pushed into a post during football practice, hitting his knee. And the accident took him and his parents down a path they never imagined.

The next days followed with occasional pain, but Fletcher and his teammates hoped he’d be OK by Saturday’s game. At practice that week, though, his knee buckled. Concerned, his parents took him to the doctor near their North Carolina hometown, and it became clear that Fletcher wouldn’t be playing on Saturday, after all.

A magnetic resonance imaging (MRI) test showed that Fletcher had completely torn his anterior cruciate ligament (ACL), a major ligament in the knee that protects cartilage and keeps the knee stable. If Fletcher ever wanted to play football again, he would need to have surgery. The question was, when?

Because kids’ bones are still growing, timing a child’s ACL surgery can be tricky, so most doctors prefer to wait until the child’s growth plates (soft parts of the bone that aid in growth) have totally hardened (usually around 15 to 16 years old), making surgery much less risky. Operating too soon could put Fletcher’s growth plates at risk, but waiting until his bones had fully matured would mean he couldn’t play any sports—or even fully participate in gym class or recess—for at least seven years.

His entire life would have to change.

“Sports are a huge part of Fletcher’s life,” says Fletcher’s father, Kerry. “He loves football and basketball, and we’re always outside with him, so it was emotional for us early on.” “We just weren’t sure if we would find someone to help him.”

Click to watch a video of Fletcher playing football after his surgery

Unwilling to settle, Fletcher’s parents researched online and learned about a procedure done by Mininder Kocher, MD, MPH, orthopedic surgeon at Boston Children’s Hospital’s Orthopedic Center that could spare Fletcher’s growth plates, and possibly get him back into sports in six months, rather than seven years.

“Waiting to operate until a child is a teenager might not only change his peer group and identity, but could also be dangerous for his knee,” says Kocher. “Since the ACL stabilizes the knee and protects its cartilage, without it, that cartilage is at risk for injury.” Studies also show that when cartilage gets damaged, children can start to get arthritis in as little as 10 years’ time: If Fletcher hurt his cartilage before surgery, he could struggle with arthritis before he even graduated high school.

Boston Children’s innovative surgical approach wouldn’t damage Fletcher’s growth plates, and instead would use an illio-tibial (IT) band grafting procedure to replace Fletcher’s ACL quickly and safely. Originally developed by Boston Children’s Lyle Micheli, MD research shows that 95 percent of children who undergo the surgery get back to their sports in approximately six months, and have only a 3 percent chance of ever needing another ACL surgery again.

“We get kids from all over the country and the world who come here specifically for this surgery because it’s innovative, and we perform it early enough to get them back into sports,” says Kocher. “Our Center is unique because we have expertise in both sports medicine and in pediatric orthopedics—it’s a special knowledge and skill set.”

That was all the Gallimores needed to hear. After sending Fletcher’s MRI results to Kocher and receiving the news that Fletcher was a good candidate for surgery, they flew to Boston.

“We had our pre-operative appointment Monday, Fletcher had his surgery on Tuesday, and we were back home in North Carolina on Friday,” Kerry says of the swift procedure.

Though Fletcher wasn’t in any pain from the surgery, he did need to start his recovery process, which included wearing a brace and using crutches, as well as using a machine to help him straighten his leg. He attended physical therapy regularly for four months, and was able to do a lot of the exercises at home.

At Fletcher’s five-month check-up with Kocher, he learned that he had recovered completely, and it was safe to play football again. Kocher’s expertise, combined with Fletcher’s hard work and dedication to recovery paid off for him this football season:  He recently received co-offensive MVP award for his team.

When Fletcher thinks about the last year of his life, he’s honest. “I’m really glad it’s over,” he says “but now I can plan on playing sports for a long time.”

 Learn more about Boston Children’s research on treating ACL tears, and how athletes can work to prevent ACL and other sports injuries from Boston Children’s Division of Sports Medicine.

To make an appointment with our ACL experts call 617-355-6021 or request an appointment online.