Background: Year-round competitive sports places the youth athlete at risk for injury from chronic repetitive stress. Various conditions have been reported secondary to overuse. Stress injuries to the distal femoral physis in active adolescents are rare. Hypothesis/Purpose: The purpose if this report is to highlight 3 male youth soccer players who presented with a lateral distal femoral hemiphyseal arrest and subsequent unilateral genu valgum deformity in their dominant “kicking leg” due to repetitive microtrauma a phenomenon we refer to as youth kicker’s knee. Methods: A retrospective review of adolescents that presented to our orthopedic clinic for lateral distal femoral hemiphyseal arrest secondary to chronic repetitive kicking was performed from 2010 to 2018. History, physical exam and imaging findings were obtained as well as the treatment course for all adolescents. Results: All patients were 14 years of age, and all participated in year-round high intensity soccer and American football. Patient specific data is summarized in Table 1 and 2. Imaging studies demonstrated aberration of the distal lateral femoral physis in all. (Figure 1) To address their limb deformity all adolescents were surgically treated with guided growth which was successful in correcting the mechanical axis in 2 of the 3 adolescents Patient Numbers (PN) 1 and 3. (Figure 2) The adolescent (PN 2) that failed to correct was definitively treated with a lateral distal femoral opening osteotomy successfully realigning his limb. Conclusion: Our series illustrates a unique presentation of a chronic overuse / stress injury in hyper sporting adolescents resulting in an ipsilateral genu valgum deformity. Understanding adolescent growth and developmental characteristics is paramount to appropriate care, prevention, and treatment of physeal injuries that may occur from repetitive overuse and avoid surgery in these young athletes when possible. [Table: see text][Table: see text][Figure: see text][Figure: see text]
Purpose To evaluate the predictive value of magnetic resonance imaging in determining hamstring autograft size preoperatively for pediatric anterior cruciate ligament reconstruction. Methods We conducted an analysis of patients younger than 18 years who underwent quadrupled hamstring autograft anterior cruciate ligament reconstruction. Semitendinosus tendon (ST) and gracilis tendon (GT) cross-sectional areas were measured on preoperative knee magnetic resonance imaging scans. Height, weight, body mass index, and sex were analyzed using ordinal regression analysis. A classification and regression tree (CART) was constructed to identify predictors of the predetermined intraoperative graft size of 8 mm or greater. Sensitivity and specificity were determined based on specified predictors. Results This study included 102 patients (52 female and 50 male patients). The average age was 15.8 ± 1.4 years. At the time of surgery, 38 patients (37.3%) had open physes, with an average age of 13.4 ± 0.96 years. Of the 102 patients, 55 (53.9%) had 8-mm or larger grafts, 31 (30.4%) had 7.5-mm grafts, and 16 (15.7%) had 7-mm or smaller grafts. In 12 patients (31.6%) with open physes, the graft size was less than 8 mm. Male patients were more likely to have 8-mm or larger grafts ( P < .001), as were patients with a greater height (170.1 ± 7.3 cm vs 161.1 ± 12.0 cm, P = .013) and those with a greater weight (79.7 ± 23.4 kg vs 57.1 ± 16.2 kg, P = .005). For all patients, predictive modeling determined that if the cross-sectional areas of the ST and GT were 31.2 mm 2 or greater, then 87.5% of patients would have a graft size of 8 mm or greater with an 80% sensitivity and 74% specificity. Similarly, if the cross-sectional areas of the ST and GT were 31.4 mm 2 or greater in patients with open physes, then 100% of patients would have a graft size of 8 mm or greater with a 46% sensitivity and 99% specificity. Conclusions A preoperative summation of the cross-sectional areas of the ST and GT greater than 31 mm 2 in patients younger than 18 years with open or closed physes can help the surgeon preoperatively predict which patients will have an intraoperative graft size of 8 mm or greater. The risk factors for a smaller graft size include female sex, a shorter height, and a lighter weight. Level of Evidence Level III, retrospective comparative study.
Year-round competitive sports place the youth athlete at risk for injury from chronic repetitive stress. Stress injuries to the distal femoral physis in adolescents are rare. This report highlights three male youth soccer players who presented with a lateral distal femoral hemiphyseal arrest and a subsequent unilateral genu valgum deformity in their dominant “kicking leg” due to repetitive microtrauma, a phenomenon we refer to as youth kicker’s knee. Mean age was 14.2 years, and all participated in year-round soccer and American football. Imaging demonstrated aberration of the distal lateral femoral physis. All patients were surgically treated. Our series illustrates a unique presentation of a chronic overuse injury in hyper sporting adolescents resulting in an ipsilateral genu valgum deformity. Understanding adolescent growth and developmental characteristics is paramount to appropriate care, prevention, and treatment of physeal injuries that may occur from repetitive overuse and avoid surgery in these young athletes when possible.
the first 2 weeks by 60%. The mean return to sport activity was 35 days and their previous level of professional activity was reached after 90 days. Conclusion: Symptoms improvement and reduced post-operative pain allowed a return to sports activity at the same level in a short time in all patients. The arthroscopic technique in the prone assessment is confirmed to be extremely valid and affordable, reporting a lower complication rate compared to that described in the literature with the open technique. Disclosure: The author(s) have no commercial interest to disclose.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.