[Knee arthroscopy in children].
OBJECTIVE
Between 1990 and 1998, 110 knee arthroscopies were performed in children. We analyzed the epidemiology and diagnostic data and studied the correlation between clinical and radiographic findings and the final diagnosis after arthroscopy in order to establish a consensus on use of knee arthroscopy in children.


METHODS
We made a retrospective analysis of 110 knee arthroscopies performed in children, classing the patients in three age groups: 0-5 years, 5-10 years, 10-17 years. Clinical and radiological findings were compared with the arthroscopy findings.


RESULTS
One or more arthroscopies were performed in 56 boys and 48 girls. Mean age at the time of the procedure was 12 years 4 months. There were 11 children aged 0-5 years, 14 aged 5-10 years and 85 aged 10-17 years. The main pathology was arthritis in the 0-5 year and 5-10 year age groups. Trauma was more frequent in the older children. Knee arthroscopy was found to be normal in 19 cases.


CONCLUSIONS
For most surgery teams, arthroscopy is indicated for arthritis of the knee. Arthroscopy may also be needed for hemarthrosis. In these contexts, arthroscopy is both a diagnostic and therapeutic procedure. Our analysis demonstrates that emergency arthroscopy is only warranted for free floating osteochondral fractures and fractures of the tibial articular surfaces, with the exception of the tibial spines. Arthroscopy may be performed later in other cases after careful physical examination and radiographic series. We had 19 normal arthroscopies and 10 that showed femoropatellar chondropathies and plicas that could explain knee pain. We recommend arthrography before arthroscopy to avoid unnecessary procedures.


CONCLUSIONS
Arthritis of the knee is an excellent indication for arthroscopy. Painful and acute hemarthrosis requires attentive physical exams and x-rays before making the decision for surgery.
Deblock
N
N
Service d'Orthopédie Infantile, CHU Lapeyronie, 34295 Montpellier Cedex 5.
Mazeau
P
P
Ceroni
D
D
Scotto Di Luzio
A
A
Meyer Zu Reckendorf
G
G
Diméglio
A
A
D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D001170:Arthritis, Infectious / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001175:Arthrography; D001182:Arthroscopy / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006395:Hemarthrosis / Q000209:etiology; D006801:Humans; D007223:Infant; D007594:Joint Loose Bodies / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007718:Knee Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010146:Pain / Q000209:etiology; D018579:Patient Selection; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome