Knee ligament and meniscus injuries in children and teenagers

Knee ligament and meniscus injuries in children and teenagers are becoming more numerous because of increased sports participation but also better diagnosis. Meniscus injuries occur either in a normal meniscus or due to a congenital anomaly. The diagnosis is made clinically and confirmed by MRI. Treatment depends on the findings: meniscoplasty for discoid meniscus and primary repair of meniscus tears. Meniscus preservation is the rule. Injuries to the central pivot of the knee typically involve either the anterior cruciate ligament (ACL) or the tibial spine. Age, anatomy and the mechanism of injury determine the specific nature of the injury. The treatment of tibial spine fractures is highly standardized and typically surgical, with the aim of limiting residual laxity. ACL tears can be treated either by primary repair or non-surgically with guided rehabilitation. ACL reconstruction in skeletally immature patients is feasible as long as the growth plates are protected. The rate of residual laxity or retear is lower when anterolateral reconstruction is performed simultaneously. LEVEL OF EVIDENCE: Expert opinion.