The most common problems in children’s knees include ACL tears, discoid meniscus, and osteochondritis dissecans [OCD].
How it happens
ACL tears occur usually from a sports injury. Discoid meniscus is a congenital problem, where the child is born with a meniscus that is too large, and they frequently tear and cause symptoms of pain or popping in the knee. The cause of OCD is not clear, but it can cause pain in the child’s knee and require surgery in some cases.
How it feels
When the ACL is torn the knee is painful and swollen. Subsequently, the child may have a sense of instability or giving-way. A discoid meniscus will often cause pain or a sense of catching or locking. OCD lesions generally cause pain that is worse with activity.
How it is fixed
These conditions do not always require surgery in children. When surgery is indicated, Dr. Marx uses specific techniques to avoid growth plate injury in children. These techniques vary depending on the age and skeletal maturity of the child. Discoid meniscus can be treated either through resection of the extra meniscus or repair, depending on the type of meniscus. Lastly, OCD lesions are usually treated with arthroscopic drilling, which is a relatively small procedure. In some cases, more extensive surgery is required.
Crutches are required following ACL surgery or OCD drilling. If a discoid meniscus is repaired with sutures, crutches are also required, but, if only a portion of the meniscus is removed, crutches may only be needed for a few days. Physical therapy is required after surgery for each of these conditions.