Trauma of the Knee Joint in Children and Adolescents

Patients and Methods:

During a 12-year period (1/88–12/99), 4,526 arthroscopic (ASC) of the knee joint were performed at our clinic. 279 of the patients involved were aged between 0 an 17 years (at the time of the procedure). 162 out of these 279 ASCs were performed posttraumatically after fresh injuries; 32 patients were children (age 6–12 years), 130 adolescents (age 13–17 years).

Results: In 131 patients (81%), we established findings requiring treatment, which led to immediate arthroscopic intervention or open surgery. Findings requiring no direct therapeutic action were established during the procedure in only 31 patients (19%), with hemostasis (eight patients = 5%) and/or flushing-out of the hemarthrosis with insertion of a drain being regarded as an extended diagnostic ASC.

On the basis of the findings established during the procecure, a clarification by magnetic resonance imaging (MRI) would have been promising and sufficient in only one patient (0.6%) with an isolated synovitis. In the other 30 out of these 31 patients with extended diagnostic ASC (18%), sufficient diagnostic clarification was only achieved arthroscopically.

Conclusions: In view of these results, we consider that only in rare, exceptional cases (e. g., relative or absolute contraindications to arthroscopy or anesthesia), there is a posttraumatic indication for a preoperative knee MRI in children and adolescents.