The significance of hemarthrosis of the knee in children

Eiskjær, Søren Peter; Larsen, Sören Toksvig; Schmidt, Maximilian

doi:10.1007/bf00454494

Cited by 86 publications

(45 citation statements)

References 9 publications

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“…The combination of an osteochondral fracture with an acute dislocation of the patella was believed to be uncommon before the availability of arthroscopy. Eiskjaer et al 9 performed 40 arthroscopic evaluations because of hemarthrosis and reported 3 (8%) osteochondral fractures. None of the fractures were detected on standard radiographs of the knee.…”

Section: Resultsmentioning

confidence: 98%

Acute Hemarthrosis of the Knee in Children

et al. 1995

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The purpose of this study was to determine the cause of acute hemarthrosis of the knee in a prospective pediatric patient population. Between December 1988 and August 1991, 21 consecutive children who were seen with an acute traumatic hemarthrosis of the knee had an arthroscopic evaluation. The average age of the children at the time of injury was 14 years, 3 months (range, 10 to 17 years). The mechanism of injury was a torsional strain to the knee in 12 (71%) of the 17 patients who could accurately remember the injury. The initial evaluation included a history, physical examination, and anteroposterior, lateral, sunrise, and comparison radiographs. The arthroscopic procedure was performed under general anesthesia, and the arthroscopic findings were compared with preoperative findings. During arthroscopic examination, an osteochondral fracture of the lateral femoral condyle or patella was identified in 14 (67%) of the 21 patients. Preoperative radiographs failed to identify the fracture in 5 (36%) of the 14 patients who had an osteochondral fracture. The anterior cruciate ligament was visualized and probed; an injury was found in only two cases (10%). We concluded that in children an acute traumatic hemarthrosis reflects a major injury to the knee. The children in this study had a high frequency of osteochondral fractures; ACL injuries were found in only two patients. Because of the unreliable nature of radiographic evaluation, arthroscopic evaluation is a valuable tool in differential diagnosis and treatment of acute hemarthrosis of the knee.

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Section: Resultsmentioning

confidence: 98%

Acute Hemarthrosis of the Knee in Children

et al. 1995

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“…Early reports" suggested that integrity of the ACL may be of minor importance in children but subsequent studies12"13 have found that ACL laxity can be troublesome. Eiskjaer et al 14 Many childrens' knee disorders are of unknown aetiology and are self limiting and only the presence of debilitating symptoms or unequivocal clinical features should justify operation without first using conservative measures. The difficulties in eliciting symptoms and signs make the idea of arthroscopy attractive but surgically treatable pathology is unusual and this makes excessive use ofthe technique questionable.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopy in Children

Hope

1991

J R Soc Med

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Arthroscopy was performed on the knees of 67 children aged 2–16 years with an overall clinical diagnostic accuracy of 45%. The most common clinical diagnoses were meniscal tear and patello-femoral pain and the accuracy of these diagnoses was 33% and 59% respectively. Diagnostic accuracy seemed unrelated to age. Arthroscopy led to definitive treatment which relieved symptoms in 21 (31%) of cases, revealed a diagnosis only in 43 (64%), and was non-contributory in 3 (4.5%). The procedure did not significantly help patients with patello-femoral pain.

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“…[1][2][3][4][5][6][7] The true incidence of midsubstance ACL rupture in children is unknown, but ACL injury has been reported in 10% to 65% of pediatric knees with acute hemarthrosis. [8][9][10][11] Shea et al 12 found that ACL injuries accounted for 6.7% of total injuries and 30.8% of all knee injuries in soccer players aged 5 to 18 years in the United States. Bony ACL avulsions are more likely to occur in preadolescents, whereas adolescents are more prone to ACL substance tears.…”

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confidence: 99%

All-Epiphyseal, All-Inside Anterior Cruciate Ligament Reconstruction Technique for Skeletally Immature Patients

McCarthy

Graziano

Green

et al. 2012

Arthroscopy Techniques

106

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Anterior cruciate ligament (ACL) injuries are an increasingly recognized problem in the juvenile population. Unfortunately, outcomes with conservative treatment are extremely poor. Adult reconstruction techniques are inappropriate to treat skeletally immature patients because of the risk of physeal complications, including limb-length discrepancy and angular deformities. "Physealsparing" reconstruction techniques exist, but their ability to restore knee stability is not well understood. We describe an all-epiphyseal ACL reconstruction for use in skeletally immature patients. This is an all-inside technique with the femoral tunnel drilled retrograde and the tibial tunnel drilled retrograde; both tunnels are entirely within the epiphysis. Fixation of the hamstring autograft is achieved with soft-tissue buttons on both the femur and tibia. We present case examples for 2 patients who underwent the all-inside, all-epiphyseal reconstruction and our postoperative rehabilitation protocol. We present a novel surgical technique for an all-inside, all-epiphyseal ACL reconstruction in skeletally immature patients.

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The significance of hemarthrosis of the knee in children

Cited by 86 publications

References 9 publications

Acute Hemarthrosis of the Knee in Children

Acute Hemarthrosis of the Knee in Children

Arthroscopy in Children

All-Epiphyseal, All-Inside Anterior Cruciate Ligament Reconstruction Technique for Skeletally Immature Patients

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