title: Knee injuries in children and adolescents.
abstract: As more children and adolescents are involved in sporting activities, the number of injuries to immature knees rises. We will focus on three entities: ruptures of the anterior cruciate ligament, patellar dislocation, and meniscal injuries. There is a trend in recent literature toward early reconstruction of the anterior cruciate ligament in children and adolescents. In this article, we will try to highlight the anatomic specialities and the diagnostic steps toward the correct diagnosis, review technical considerations and risks of the different surgical techniques, and present outcomes and offer a treatment recommendation. The treatment of patellar dislocation has changed considerably since we gained a better understanding of the unique anatomy of the patellofemoral joint. We will show diagnostic steps and risk factors for recurrent patellar dislocation, discuss conservative and different operative therapy options, and present a modified technique to achieve a dynamic reconstruction of the medial patellofemoral ligament without damage to the growth plates. Meniscal tears and discoid menisci are rare in comparison to the other injuries. We will herein explain what specialities in the anatomy should be considered in children and adolescents concerning the menisci, and present the diagnostic steps and treatment options available.
authors.affiliation: Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Hoetzel
authors.affiliation: Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Preiss
authors.affiliation: Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany.
authors.forename: M A
authors.initials: MA
authors.lastname: Heitmann
authors.affiliation: Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany. k.frosch@asklepios.com.
authors.forename: K-H
authors.initials: KH
authors.lastname: Frosch
keywords: Anterior cruciate ligament; Knee injuriy; Meniscal rupture; Patella dislocation
references.citation: Arthroscopy. 2002 Nov-Dec;18(9):955-9
references.pmid: 12426537
references.citation: Arthroscopy. 2010 Aug;26(8):1083-7
references.pmid: 20678706
references.citation: J Knee Surg. 2009 Jul;22(3):180-6
references.pmid: 19634719
references.citation: Knee Surg Sports Traumatol Arthrosc. 2007 Apr;15(4):320-7
references.pmid: 16909299
references.citation: Am J Sports Med. 2010 May;38(5):976-82
references.pmid: 20299545
references.citation: J Pediatr Orthop. 2011 Dec;31(8):811-7
references.pmid: 22101657
references.citation: J Pediatr Orthop. 2002 Jul-Aug;22(4):452-7
references.pmid: 12131440
references.citation: Am J Sports Med. 2011 Aug;39(8):1756-61
references.pmid: 21566067
references.citation: Curr Opin Pediatr. 2002 Feb;14(1):54-61
references.pmid: 11880735
references.citation: Arthroscopy. 2007 Feb;23(2):157-63
references.pmid: 17276223
references.citation: J Bone Joint Surg Am. 2006 Sep;88 Suppl 1 Pt 2:283-93
references.pmid: 16951100
references.citation: Orthop Surg. 2011 Nov;3(4):219-23
references.pmid: 22021136
references.citation: Sports Med Arthrosc. 2011 Mar;19(1):34-43
references.pmid: 21293236
references.citation: J Bone Joint Surg Am. 2013 Mar 6;95(5):e28
references.pmid: 23467876
references.citation: J Bone Joint Surg Br. 2005 Apr;87(4):577-82
references.pmid: 15795215
references.citation: Am J Knee Surg. 1999 Spring;12 (2):83-7
references.pmid: 10323498
references.citation: Arthroscopy. 2006 Dec;22(12 ):1325-30
references.pmid: 17157732
references.citation: Knee Surg Sports Traumatol Arthrosc. 2010 Nov;18(11):1496-500
references.pmid: 20182870
references.citation: Arthroscopy. 2008 Jul;24(7):824-33
references.pmid: 18589272
references.citation: Am J Sports Med. 1981 Jul-Aug;9(4):270-4
references.pmid: 7258473
references.citation: J Pediatr Orthop. 1993 Jul-Aug;13(4):506-10
references.pmid: 8370785
references.citation: Acta Orthop. 2005 Oct;76(5):699-704
references.pmid: 16263618
references.citation: Arthroscopy. 2012 Jan;28(1):123-30
references.pmid: 22074619
references.citation: J Bone Joint Surg Am. 2008 Mar;90(3):463-70
references.pmid: 18310694
references.citation: Arthroscopy. 1992;8(4):526-30
references.pmid: 1466716
references.citation: Arthroscopy. 2010 Nov;26(11):1530-8
references.pmid: 20888170
references.citation: Am J Orthop (Belle Mead NJ). 1997 Jan;26(1):18-23
references.pmid: 9021030
references.citation: J Knee Surg. 2012 Mar;25(1):51-7
references.pmid: 22624248
references.citation: Z Orthop Unfall. 2011 Dec;149(6):630-45
references.pmid: 21544786
references.citation: Am J Sports Med. 2004 Jul-Aug;32(5):1114-21
references.pmid: 15262631
references.citation: Radiology. 1999 Dec;213(3):697-704
references.pmid: 10580941
references.citation: Clin Sports Med. 2002 Jul;21(3):499-519
references.pmid: 12365240
references.citation: Orthop Clin North Am. 2003 Jan;34(1):149-67
references.pmid: 12735207
references.citation: J Bone Joint Surg Br. 1977 May;59(2):241-2
references.pmid: 873986
references.citation: Eur J Radiol. 2011 Sep;79(3):415-20
references.pmid: 20638212
references.citation: J Bone Joint Surg Br. 2002 Jan;84(1):38-41
references.pmid: 11837830
references.citation: Ann Surg. 1899 Jan;29(1):62-8
references.pmid: 17860670
references.citation: Instr Course Lect. 1998;47:351-9
references.pmid: 9571437
references.citation: Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):793-800
references.pmid: 22207028
references.citation: Am J Sports Med. 1998 Jan-Feb;26(1):52-5
references.pmid: 9474401
references.citation: Am J Sports Med. 1995 Jul-Aug;23 (4):431-5
references.pmid: 7573652
references.citation: J Bone Joint Surg Br. 1995 Nov;77(6):890-4
references.pmid: 7593101
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Aug;21(8):1895-903
references.pmid: 23085822
references.citation: Arthroscopy. 2003 Apr;19(4):346-52
references.pmid: 12671616
references.citation: Arthroscopy. 2011 May;27(5):704-16
references.pmid: 21552340
references.citation: Clin Orthop Relat Res. 1972;88:67-9
references.pmid: 5086583
references.citation: Scand J Med Sci Sports. 2008 Aug;18(4):442-6
references.pmid: 18067514
references.citation: J Bone Joint Surg Br. 1948 Nov;30B(4):664-70
references.pmid: 18894618
references.citation: Am J Sports Med. 2013 Mar;41(3):678-83
references.pmid: 23339836
references.citation: Acta Orthop Belg. 2011 Feb;77(1):18-20
references.pmid: 21473440
references.citation: Knee Surg Sports Traumatol Arthrosc. 1994;2(1):19-26
references.pmid: 7584171
references.citation: Am J Sports Med. 2008 Dec;36(12):2301-9
references.pmid: 18762668
references.citation: J Bone Joint Surg Am. 2013 Jan 16;95(2):176-83
references.pmid: 23441343
references.citation: Am J Sports Med. 2010 Nov;38(11):2320-7
references.pmid: 20713643
references.citation: Am J Sports Med. 2002 Jul-Aug;30(4):589-600
references.pmid: 12130415
references.citation: Clin Orthop Relat Res. 1979 Oct;(144):63-9
references.pmid: 535252
references.citation: Knee Surg Sports Traumatol Arthrosc. 2006 Mar;14(3):273-7
references.pmid: 16311766
references.citation: J Pediatr Orthop. 2011 Jul-Aug;31(5):496-500
references.pmid: 21654455
references.citation: Unfallchirurg. 2012 Sep;115(9):848-54
references.pmid: 22476376
references.citation: Arthroscopy. 1989;5(2):101-9
references.pmid: 2736005
references.citation: Knee Surg Sports Traumatol Arthrosc. 2009 May;17(5):508-12
references.pmid: 19165466
references.citation: J Pediatr Orthop. 2012 Mar;32(2):145-55
references.pmid: 22327448
references.citation: Sports Med. 2003;33(6):455-71
references.pmid: 12744718
references.citation: J Bone Joint Surg Br. 2000 Mar;82(2):217-21
references.pmid: 10755429
references.citation: Knee Surg Sports Traumatol Arthrosc. 2009 Jul;17 (7):748-55
references.pmid: 19252897
references.citation: Am J Sports Med. 2000 Jul-Aug;28(4):472-9
references.pmid: 10921637
references.citation: Am J Sports Med. 1986 Mar-Apr;14 (2):117-20
references.pmid: 3717480
references.citation: Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12 ):2067-71
references.pmid: 21594662
references.citation: Am J Sports Med. 2011 Jul;39(7):1444-9
references.pmid: 21372313
references.citation: Arthroscopy. 2010 Nov;26(11):1539-50
references.pmid: 21035009
references.citation: J Bone Joint Surg Am. 1995 Sep;77(9):1357-61
references.pmid: 7673286
references.citation: Arthroscopy. 1989;5(3):197-200
references.pmid: 2775393
references.citation: Clin Orthop Relat Res. 2007 Feb;455:93-101
references.pmid: 17279039
references.citation: J Pediatr Orthop. 2012 Dec;32(8):760-4
references.pmid: 23147616
references.citation: J Pediatr Orthop. 2003 Mar-Apr;23(2):199-202
references.pmid: 12604951