KNEE

Conditions Diagnosed & Treated

Below is an outline of some of the major paediatric orthopaedics disorders that we specialise in, but typically most paediatric orthopaedic conditions that warrant a specialist referral can be successfully investigated through our team. If your child is suffering from any orthopaedic or sport issue and are looking for definitive medical support then please let us know.

Common Paediatric Conditions

Patella Instability

In children, Patella Instability refers to the kneecap (patella) moving out of its normal position in the knee joint, often due to a direct blow, sudden twist, or inherent joint laxity, leading to pain, swelling, and difficulty in straightening the knee.

First time and Recurrent Patella Dislocation

In paediatric patients, a first-time patella dislocation typically occurs due to an injury or sudden movement, causing the kneecap to move out of place, while recurrent patella dislocations happen when the knee becomes more susceptible to dislocating again after the initial incident, often with less force required.

Apophysis Injuries

Osgood-Schlatter Disease: This condition in children and adolescents involves inflammation and pain at the tibial tuberosity, the bony bump below the knee. It’s often caused by repetitive stress on the growth plate in the area, especially in active children.

Sinding-Larsen-Johansson Syndrome: Similar to Osgood-Schlatter, this syndrome occurs in growing children and involves pain and inflammation at the lower part of the kneecap, often related to repetitive stress or overuse, particularly in sports that involve jumping and running.

Bowed or Knocked knees

In children, “bowed knees” (genu varum) refers to a condition where the legs curve outward, creating a noticeable gap between the knees when standing straight. “Knocked knees” (genu valgum) is the opposite, where the knees angle inward and touch each other while the ankles remain apart. Both conditions are common in childhood development and usually correct themselves over time, but severe cases may require medical intervention.

Sports Injury: ACL rupture

In children, an Anterior Cruciate Ligament (ACL) rupture involves the tearing of the ACL, a key ligament in the knee, often due to sudden stops, changes in direction, or direct impacts. This injury can cause knee instability, pain, and swelling, and is a concern in paediatric sports medicine.

Sports Injury: Meniscal tear

In children, a meniscal tear refers to an injury to the meniscus, the cartilage in the knee joint that acts as a shock absorber. This type of tear can result from twisting or turning quickly, often during sports, leading to pain, swelling, and difficulty moving the knee.

Fractures and Dislocations

Salter Harris fractures or growth plate injuries

Salter-Harris fractures are injuries to the growth plate area of a child’s bone and are categorised into five types, each varying in severity and impact on future bone growth.

Patella Fractures

Patella fractures in children involve the breaking of the kneecap bone (patella), often due to a direct blow or a fall on the knee. These fractures can cause pain, swelling, and difficulty in bending or straightening the knee, requiring medical evaluation and treatment for proper healing.

Femoral Fractures

Femoral fractures in children refer to breaks in the femur, the thigh bone. These fractures can occur as a result of significant trauma, falls, or accidents, and may require surgical intervention for proper alignment and healing in paediatric patients.

Tibial Fractures

Tibial fractures in children involve breaks in the tibia, the larger of the two lower leg bones. These fractures can occur due to various reasons, including falls, sports injuries, or accidents, and may necessitate medical attention to ensure proper healing and restoration of leg function.

STRESS fractures

Stress fractures in children occur when a bone is unable to withstand normal stress or load due to weakened bone structure, often seen in metabolic conditions or as result of osteoporosis or as a result of repetitive activities. These fractures can happen in various bones and may require special attention, especially in paediatric patients with underlying medical conditions.

Avulsion Injuries

Tibial spine / ACL

A tibial spine avulsion injury often involves the separation of a small bony prominence on the tibia where the anterior cruciate ligament (ACL) attaches. This injury can occur due to sudden twisting or hyperextension of the knee, leading to pain and instability, particularly in children and adolescents.

tibial tuberosity

The tibial tuberosity is a bony prominence located just below the knee joint, and it serves as the attachment point for the patellar tendon. Injuries or conditions related to the tibial tuberosity can include Osgood-Schlatter disease, where there is inflammation and pain at this site due to repetitive stress on the growth plate, especially in active children.

Ligament Injuries

Anterior Cruciate Ligament

The Anterior Cruciate Ligament (ACL) in paediatric patients is a critical ligament in the knee that provides stability and controls the forward movement of the tibia (shin bone) in relation to the femur (thigh bone). Injuries to the ACL, often seen in active children and adolescents, can result from sudden twists or impacts to the knee and may require surgical intervention to regain stability and function in the knee joint.

Posterior Cruciate Ligament

The Posterior Cruciate Ligament (PCL) in paediatric patients is a ligament in the knee that helps stabilize the joint by preventing the tibia (shin bone) from moving too far backward in relation to the femur (thigh bone). PCL injuries, though less common than ACL injuries, can occur in children due to traumatic events like falls or accidents, and may require medical evaluation and treatment for optimal recovery and knee joint stability.

Medial Collateral Ligament

The Medial Collateral Ligament (MCL) in paediatric patients is a ligament that runs along the inner side of the knee joint, providing stability and preventing excessive sideways movement of the knee. Injuries to the MCL can occur in children due to forces that push the knee outward, such as twisting or direct impact. These injuries may lead to pain, swelling, and instability of the knee, and often heal well with conservative treatment like rest and physical therapy in paediatric cases.

Lateral Collateral Ligament

The Lateral Collateral Ligament (LCL) in paediatric patients is a ligament located on the outer side of the knee joint. It plays a crucial role in stabilizing the knee and preventing excessive sideways movement, particularly in the direction of the inner knee. Injuries to the LCL can occur in children, often due to forces that push the knee inward, and may result in pain, swelling, and instability of the knee. Treatment for LCL injuries in paediatric cases may include rest, physical therapy, or, in severe cases, surgical intervention.

Tendon Injuries

Runners Knee (ITB injury)

Runner’s Knee, also known as iliotibial band (ITB) injury, is a common condition in paediatric and adolescent athletes, particularly runners and cyclists. It involves pain and inflammation on the outer side of the knee where the ITB, a thick band of connective tissue, rubs against the femur (thigh bone). This condition can result from overuse or improper biomechanics and may require rest, physical therapy, and adjustments to training techniques to alleviate symptoms and prevent recurrence in young athletes.

Jumpers Knee (Patella Tendonitis)

Jumpers Knee, also known as Patella Tendonitis, is a condition that affects the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). In paediatric patients, particularly in active individuals involved in sports like basketball or volleyball, this condition can occur due to repetitive jumping and landing. It leads to pain and inflammation in the front of the knee. Treatment typically involves rest, physical therapy, and modifying activity to allow the tendon to heal properly and reduce strain on it.

Patella Tendon Rupture

Patella Tendon Rupture in paediatric patients is a severe injury involving a complete tear of the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). This injury can result from sudden forceful contractions of the quadriceps muscles or a direct impact to the knee. It leads to a loss of knee extension and difficulty in walking. Patella tendon ruptures in children often require surgical repair followed by rehabilitation to regain knee function and strength.

Cartilage Injuries

Osteochondritis Dissecans

Osteochondritis Dissecans is a joint condition where a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. This can lead to joint pain and instability, often affecting the knees, elbows, or ankles in children and adolescents.

Osteochondral Defects

Osteochondral Defects refer to damage to both the bone and the cartilage in a joint, often caused by injury or lack of blood supply to the area. These defects can lead to pain, swelling, and joint dysfunction in paediatric patients.

Simple limb deformity

Leg length discrepancy

Leg length discrepancy in paediatric patients refers to a condition where one leg is shorter than the other. This discrepancy can result from various factors, including developmental issues, fractures, or medical conditions. It may cause problems with posture, walking, and alignment in children, and treatment options may include orthotics, surgical interventions, or other therapeutic measures to address the imbalance and improve function.

Genu Varus / Bow legged / Bloats Disease

Genu Varus, commonly known as “bow-legged” or Blount’s Disease in paediatric patients, is a condition where the legs appear to curve outward at the knees, creating a distinct bow-legged appearance. Blount’s Disease is a more severe and pathological form of genu varus and typically develops during early childhood. It results from abnormal growth at the upper part of the tibia (shinbone) and can lead to deformity if left untreated. Management may involve bracing or surgical intervention in severe cases to correct the alignment of the legs.

Genu Valgus / Knocked knees

Genu Valgus, commonly known as “knocked knees,” is a condition in paediatric patients where the knees angle inward and touch each other while the ankles remain apart, resulting in a noticeable gap between the ankles. This condition is often seen in young children as part of their normal growth and development and typically corrects itself as they grow older. However, severe or persistent cases may require medical evaluation and possible intervention to address the alignment of the legs.

Meniscal Injuries

Meniscal tears

Meniscal tears in paediatric patients involve damage to the meniscus, which is a wedge-shaped cartilage in the knee joint that acts as a shock absorber. These tears can occur due to twisting or direct force on the knee and may result in symptoms like pain, swelling, and limited range of motion. Treatment options for meniscal tears in children may include rest, physical therapy, and, in some cases, surgical intervention to repair or remove the damaged tissue, depending on the severity and location of the tear.

Discoid Meniscus

Discoid Meniscus is a condition that can affect the knee joint in paediatric patients. It involves an abnormally shaped meniscus, which is the wedge-shaped cartilage in the knee joint that acts as a shock absorber. In this condition, the meniscus is thicker and more disc-shaped than the typical crescent shape. Discoid meniscus can lead to symptoms such as pain, swelling, and a feeling of instability in the knee. Treatment options may include observation, physical therapy, or, in some cases, surgical intervention to address the abnormal shape of the meniscus and alleviate symptoms.

FAT PAd Injuries

Fat Pad Injuries

Fat pad injuries in paediatric patients involve damage to the infrapatellar fat pad, which is a cushion of fatty tissue located just below the kneecap (patella) in the knee joint. These injuries can occur due to direct trauma or repetitive stress to the knee and may result in pain, swelling, and tenderness in the front of the knee. Treatment options for fat pad injuries in children may include rest, physical therapy, anti-inflammatory medications, and, in some cases, injections to alleviate symptoms and promote healing.

Baker’s Cyst Injuries

BAKER’S CYST INJURIES

Baker’s Cyst injuries in paediatric patients involve damage or inflammation of a Baker’s cyst, which is a fluid-filled sac that can develop behind the knee. These cysts can form as a result of underlying knee conditions, such as arthritis or meniscal tears, and may cause swelling and discomfort at the back of the knee. Treatment for Baker’s Cyst injuries in children typically focuses on addressing the underlying knee issue and managing symptoms, which may include rest, physical therapy, medications, or, in some cases, drainage of the cyst.

What some of our patients say

Miss NN

Thank you and please accept my gratitude for a successful knee surgery and overall a very positive experience. This gold medal is for you!