[Arthroscopy of the knee joint in childhood].
OBJECTIVE
Arthroscopy is generally regarded as a method suitable exclusively for the treatment of adult patients and only occasionally used in children as a diagnostic tool. Since the number of arthroscopic procedures has considerably increased in recent years, we decided to evaluate the knee arthroscopies performed in pediatric patients, focusing on a correlation between the preoperative diagnosis and arthroscopic findings.


METHODS
The clinical records on 319 arthroscopic procedures in 311 children treated at our Department between 1995 and 2002 were retrospectively analyzed. The procedures were evaluated in view of the diagnosis established before surgery and that confirmed by arthroscopy. The patients were placed in two groups: preadolescents (younger than 13 years) and adolescents (13 to 18 years old). All patients were treated by the standard arthroscopic procedure. Except for two patients, all children underwent elective surgery of diagnostic or therapeutic reasons.


RESULTS
Mediopatelar plica was the most frequent pathology and was treated in 26% of the patients. Meniscus lesions were found in 35% of all patients, but were more frequent in the adolescent group, in which two thirds of all patients were treated for this condition. The crucial ligaments were affected in 10% of all patients. In 52 patients, no pathology was found on arthroscopic examination. There was no difference in findings between the two groups.


CONCLUSIONS
In some patients, the arthroscopic findings differed from the diagnosis established preoperatively, with the pathological condition being misdiagnosed more often in the adolescent group. The correct diagnosis was confirmed in 81.4%. The findings were negative in 16.4% of the patients, which is in agreement with the literature data.


CONCLUSIONS
Based on our experience we conclude that great caution be exercised when making the preoperative diagnosis. The expertise of the diagnosing physician and availability of feedback are emphasized.
Ortopedická klinika detí a dospelých 2. LF UK a FN v Motole, Praha. vojtech.havlas@lfmotol.cuni.cz
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D000293:Adolescent; D001182:Arthroscopy; D002648:Child; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008297:Male