Paediatric and Adolescent Knee Problems Flashcards
Knee Extensor Mechanism Pain Epidemiology
Common in adolescence
- due to increased body weight
- due to increased sporting activity
Apophysitis
Inflammation of growing tubercle where a tendon attaches
Apophysitis Common Sites
Tibial Tubercle
- Osgood-Schlatter’s Disease
Inferior pole of patella
- Sinding- Larsen-Johanssen Disease
Apophysitis Treatment
Self-limiting
Rest
Potential for physio
Patella-femoral dysfunction
Pain in the patella-femoral joint region
Patella-femoral dysfunction risk factors (4)
Female gender. Muscle imbalance Ligamentous Laxity Subtle skeletal predisposition - Genu varum -Wide hips -Femoral neck anteversion
patello-femoral dysfunction treatment
Mostly self-limiting
Physio can help
Surgery may be required in resistance causes to shift the forces on the patella
-tibial tubercle transfer
Patellar Instability
Dislocation and subluxation of the patella
Patellar Instability epidemiology
Adolescents
Patellar Instability Predisposing factors
Trauma Ligamentous Laxity Shallow femoral trochlea Genu Valgum Hip Anteversion
Patellar Instability Consequences
Osteochondral fracture
- fracture of hyaline cartilage with or without subchondral bone that may break off
- Large segments are fixed with pins
- Small segments are removed arthroscopically
Patellar Instability Treatment
Physiotherapy
Surgery to correct bony predispositions
Surgery to reconstruct the medial patellofemoral ligament
meniscal Tears (type common in children)
Peripheral
Bucket Handle
Medical Tear Deformities
Lateral meniscus can be circular instead of C-shaped.
Can be a source of pain and popping sensation
Treatment
-Arthroscopic partial meniscectomy
