|
|
|
« Back
Our 12-year-old daughter is very active in sports of all kinds. When she was 10, she hurt her knee in a soccer tournament. The X-rays at that time were negative but since her pain never went away, we finally had an MRI done last week. It turns out she has a torn meniscus of all things. We are looking into treatment options. What's generally recommended for an injury like this in children?
|
|
Knee injuries involving the meniscus (cartilage) are well-known in adults, especially athletes. But meniscal tears in children are becoming almost as common. Increased sports participation among young children and young adolescents is the main reason for the increased prevalence of this problem. Treatment in children parallels treatment for adults but with a few differences.
For one thing, growing children who have not reached skeletal maturity have a greater blood supply to the knee and its cartilage compared with adults. And the soft tissues in question (menisci) are young, not yet showing degenerative changes as seen in older adults. So the chances of self-healing and recovery are much greater in children and teens. In fact, sometimes treatment is just a hands-off policy of rest and activity modification.
But if symptoms have persisted this long (two years), it's likely that some other approach is needed. Imaging studies such as X-rays and MRI scans are useful to look for fractures, dislocation, loose fragments of bone or cartilage, and bleeding into the joint. MRIs are less reliable in children under the age of 12 because of the immature bone and soft tissues. What looks like a meniscal tear may just be the extra blood supply to the area normally present in a growing child.
When necessary, the meniscus is sewn back in place. Surgical removal of the meniscus called a meniscectomy may be needed if the meniscus just can't be saved. Surgeons avoid removing any part of the meniscus as much as possible because studies show that the loss of the meniscus results in continued pain and early arthritic changes even in children. Exactly what is done in surgery will depend on the location, size, and type of injury. The surgeon will look for any other areas of damage, especially among the knee ligaments and repair or reconstruct them at the same time. Recovery and a successful result depend on this.
In some children, there is a change in the normal shape of the meniscus, which may require a slightly different surgical approach. Instead of a C- or crescent-shaped piece of cartilage, the meniscus is more block-shaped and thicker with a disorganized array of fibers. This abnormality is called a discoid meniscus. In fact, the presence of a discoid meniscus is a second reason (besides increased sports participation) why meniscal injuries are on the rise in active children. When surgery is needed, the meniscus is reshaped and smoothed down, a procedure called saucerization. The goal is to create a stable, yet functional, meniscus.
Your daughter's surgeon will be able to advise you on the best management for her particular anatomy, injury, and activity level. The presence of a discoid meniscus is just one of many additional factors that must be taken into consideration. If surgery is required, expect a six to eight week recovery period with physical therapy and rehab. Full return-to-sports may take an extra couple of months in order to ensure strength and stability needed for twists, turns, and quick changes in direction required by many sports activities.
|
References:
|
|
|
« Back
|
|
|
|
*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
 | All content provided by eORTHOPOD® is a registered trademark of Mosaic Medical Group, L.L.C.. Content is the sole property of Mosaic Medical Group, LLC and used herein by permission. |
|
