The importance of arthroscopy in sports injuries in children and adolescents

Abstract

Within a 3-year period (1985-1988), 60 children and adolescents with knee injuries sustained mainly while skiing or playing football (soccer) underwent clinical examination, X-radiography and arthroscopy. Nearly all the patients still had open epiphyseal plates in the knee region. Arthroscopy revealed more severe intra-articular trauma than had been suspected on the basis of clinical findings. The skiing injuries most commonly involved anterior cruciate ligament tears, whereas injuries of the patellar retinaculum and medial meniscus lesions predominated in soccer injuries. On comparison with arthroscopic diagnosis, clinical diagnosis was erroneous in about 45%. The most common mistaken clinical diagnosis was "medial meniscus tear". Of the 60 knee joints subjected to arthroscopy, 40 were severely enough injured to warrant surgery. Only one had normal intra-articular findings. The study demonstrates that children and adolescents can suffer knee trauma requiring surgery, despite open growth plates. Downhill skiing and soccer are particularly risky sports in this respect. Therefore, sports injuries involving haemarthrosis are clearly an indication for arthroscopy, even in childhood and adolescence. Arthroscopy enables early identification of the type and extent of intra-articular trauma and subsequent early initiation of appropriate therapy.

Transphyseal reconstruction of the anterior cruciate ligament in prepubescent children

“…The apparent increase in the incidence of this injury has been attributed to an increased participation in sporting activities among the young, but the introduction of MRI and arthroscopy may partially account for the increased frequency of this diagnosis. 28,29 The conservative treatment of these injuries has been consistently associated with poor outcomes, including progressive instability, meniscal injuries and osteoarthrosis. Aichroth, Patel and Zorrilla 30 followed 23 patients managed conservatively for six years, by which time all had instability and ten had signs of arthrosis.…”

Magnetic Resonance Imaging of the Knee in Children and Adolescents

“…Discussion he difficulty in diagnosing pediatric and adolescent knee problems has been well documented [1][2][3][4][5][6][7][8][9][10] . Prior to the widespread access to and use of magnetic resonance imaging, knee arthroscopy had been advocated as a valuable diagnostic tool 9,[28][29][30] .…”

“…iagnosing knee disorders in children and adolescent patients can be difficult [1][2][3][4][5][6][7][8][9][10] . Harvell et al reported that a correct clinical diagnosis was made preoperatively in only 70% (141) of 202 knees in adolescent patients 5 .…”

Arthroskopie des verletzten kindlichen Kniegelenks

“…Über die in der Zeit von 1985-1988 erfaßten 60 Kniegelenkarthroskopien aufgrund von Verletzungen, die im Rahmen sportlicher Aktivitä-ten zustandegekommen waren, wurde schon an anderer Stelle berichtet [9].…”

“…Die häufigste klinische Fehldiagnose betraf, wie auch in der Literatur hervorgehoben [9], die in 12 Fällen vermutete Innenmeniskusläsion, hinter …”