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Knieband- und Kniebinnenverletzungen beim Kind

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Orthopädie und Unfallchirurgie

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Zusammenfassung

Die Inzidenz von Knieband- und Kniebinnenverletzungen nimmt auch bei Kindern und Jugendlichen rasant zu. Die klinische Diagnostik ist vor allem bei kleinen Kindern oft erschwert und daher nimmt die MRT eine zentrale Rolle ein. Durch die besseren anatomischen Kenntnisse und Weiterentwicklung der OP-Techniken, insbesondere der Arthroskopie, sind die Ergebnisse der operativen Versorgung deutlich besser geworden. Aufgrund der deutlichen Arthroseprogression bei Meniskusresektion sollte bei Meniskusrupturen eine Naht oder Refixation durchgeführt werden. Die Indikation kann bei Kindern und Jugendlichen aufgrund der besseren Heilungstendenz großzügiger gestellt werden. Es stehen heutzutage viele Naht- und Refixationstechniken zur Verfügung, um sämtliche Rupturformen adäquat behandeln zu können. Während isolierte Seitenbandverletzungen in aller Regel konservativ behandelt werden können, zeigt sich vor allem bei Rupturen der Kreuzbänder ein Trend zur operativen Versorgung, da bei chronischer Instabilität die Rate an sekundären Knorpel- und Meniskusschäden beträchtlich ist. Die klinischen Ergebnisse der meniskuserhaltenden Operationen und VKB-Rekonstruktionen bei Kindern sind sehr gut, bei Kombinationsverletzungen beeinflussen die Versorgungen sich gegenseitig positiv. Bei Rupturen des hinteren Kreuzbandes hinken die Ergebnisse, sowohl nach konservativer Therapie als auch nach HKB-Rekonstruktion, etwas nach. Es existieren mehrere speziell für Kinder angepasste Präventionsprogramme zur Reduktion von Kniebinnenverletzungen, mit denen sich beispielsweise VKB-Rupturen um bis zu 50 % reduzieren lassen. Daher sollte vor allem im Kinder- und Jugendsport der Verletzungsprävention eine große Bedeutung eingeräumt werden und alle Beteiligten mit eingebunden werden.

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Literatur

  • Abdon P, Bauer M (1989) Incidence of meniscal lesions in children. Increase associated with diagnostic arthroscopy. Acta Orthop Scand 60:710–711

    Article  CAS  PubMed  Google Scholar 

  • Agneskirchner JD, Lobenhoffer P (2004) Arthroscopic meniscus surgery. Technical-operative methods. Unfallchirurg 107:795–801

    Article  CAS  PubMed  Google Scholar 

  • Ahn JH et al (2008) Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up. Arthroscopy 24(8):888–898

    Article  PubMed  Google Scholar 

  • Anderson AF, Snyder RB, Federspiel CF, Lipscomb AB (1992) Instrumented evaluation of knee laxity: a comparison of five arthrometers. Am J Sports Med 20:135–140

    Article  CAS  PubMed  Google Scholar 

  • Angel KR, Hall DJ (1989a) Anterior cruciate ligament injury in children and adolescents. Arthroscopy 5:197–200

    Article  CAS  PubMed  Google Scholar 

  • Arnoczky SP, Warren RF (1982) Microvasculature of the human meniscus. Am J Sports Med 10:90–95

    Article  CAS  PubMed  Google Scholar 

  • Baxter MP (1988) Assessment of normal pediatric knee ligament laxity using the genucom. J Pediatr Orthop 8:546–550

    Article  CAS  PubMed  Google Scholar 

  • Beaufils P, Pujol N (2018) Meniscal repair: Technique. Orthop Traumatol Surg Res 104(1S):S137–S145

    Article  CAS  PubMed  Google Scholar 

  • Cheng L, Chan PS, Hui PW (1991) Joint laxiety in children. J Pediatr Orthop 11:752–756

    Article  CAS  PubMed  Google Scholar 

  • Choi NH, Kim NM, Kim HJ (2001) Medial and lateral discoid meniscus in the same knee. Arthroscopy 17:E9

    Article  CAS  PubMed  Google Scholar 

  • Clark H, Ogden H (1983) Development of the menisc. J Bone Joint Surg Am 65:538–547

    Article  CAS  PubMed  Google Scholar 

  • Connolly B, Babyn PS, Wright JG, Thorner PS (1996) Discoid meniscus in children: magnetic resonance imaging characteristics. Can Assoc Radiol J 47:347–354

    CAS  PubMed  Google Scholar 

  • DeFrancesco CJ, Storey EP, Shea KG, Kocher MS, Ganley TJ (2018) Challenges in the management of anterior cruciate ligament ruptures in skeletally immature. J Am Acad Orthop Surg 0:1–12

    Google Scholar 

  • Dingel A, Aoyama J, Ganley T, Shea K (2019) Pediatric ACL tears: natural history. J Pediatr Orthop 39:47–49

    Article  Google Scholar 

  • Dodwell ER, Lamont LE, Green DW, Pan TJ, Marx RG, Lyman S (2014) 20 years of pediatric anterior cruciate ligament reconstruction in New York state. Am J Sports Med 42:675–680

    Article  PubMed  Google Scholar 

  • Dunn KL, Lam KC, Mcleod TCV (2016) Early operative versus delayed or nonoperative treatment of anterior cruciate ligament injuries in pediatric patients. J Athl Train 51:425–427

    Article  PubMed  PubMed Central  Google Scholar 

  • Eiskjaer S, Larsen ST (1987) Arthroscopy of the knee in children. Acta Orthop Scand 58:273–276

    Article  CAS  PubMed  Google Scholar 

  • Ekas GR et al (2019) Knee pathology in young adults after pediatric anterior cruciate ligament injury. Am J Sports Med:1–10. https://doi.org/10.1177/0363546519837935

  • Engebretsen L, Svenningsen S, Benum P (1988) Poor results of anterior cruciate ligament repair in adolescence. Acta Orthop Scand 59:684–686

    Article  CAS  PubMed  Google Scholar 

  • Ferrari MB, Murphy CP, Gomes JLE (2019) Meniscus Repair in Children and Adolescents: A Systematic Review of Treatment Approaches, Meniscal Healing, and Outcomes. J Knee Surg 32(6):490–498. https://doi.org/10.1055/s-0038-1653943. Epub 2018 May 23. PMID: 29791926

  • Geffroy L (2020) Meniscal pathology in children and adolescents. Orthop Traumatol Surg Res:102775. https://doi.org/10.1016/j.otsr.2020.102775

  • Giorgi B (1956) Morphologic variations of the intercondylar eminence of the knee. Clin Orthop 8:209–217

    CAS  PubMed  Google Scholar 

  • Gornitzky AL, Lott A, Yellin JL, Fabricant PD, Lawrence JT, Ganley TJ (2016) Sport-Specific Yearly Risk and Incidence of Anterior Cruciate Ligament Tears in High School Athletes: A Systematic Review and Meta-analysis. Am J Sports Med 44(10):2716–2723. https://doi.org/10.1177/0363546515617742. Epub 2015 Dec 11. PMID: 26657853

  • Guzzanti V (2003) The natural history and treatment of rupture of the anterior cruciate ligament in children and adolescents. J Bone Joint Surg Br 85:618–619

    Article  CAS  PubMed  Google Scholar 

  • Hagmeijer MH et al (2019) Long-term results after repair of isolated meniscal tears among patients aged 18 years and younger: an 18-year follow-up study. Am J Sports Med 47(4):799–806

    Article  PubMed  Google Scholar 

  • Heath EL, Salmon LJ, Cooper R, Pappas E, Roe JP, Pinczewski LA (2019) 5-year survival of pediatric anterior cruciate ligament reconstruction with living donor hamstring tendon grafts. Am J Sports Med 47(1):41–51. https://doi.org/10.1177/0363546518804502. Epub 2018 Nov 26. PMID: 30476437

    Article  PubMed  Google Scholar 

  • Jackson T et al (2019) Epidemiology, injury patterns , and treatment of meniscal tears in pediatric patients a 16-year experience of a single center. Orthop J Sport Med 7:1–5

    Article  Google Scholar 

  • Kinsella SD et al (2019) Concomitant posterolateral corner injuries in skeletally immature patients with acute anterior cruciate ligament injuries. J Pediatr Orthop:1–6. https://doi.org/10.1097/BPO.0000000000001450

  • Klingele KE, Kocher MS, Hresko MT et al (2004) Discoid lateral meniscus: prevalence of peripheral rim instability. J Pediatr Orthop 24:79–78

    Article  PubMed  Google Scholar 

  • Kloeppel-Wirth S, Koltai JL, Dittmer H (1992) Significance of arthroscopy in children with knee joint injuries. Eur J Pediatr Surg 2:169–172

    Article  CAS  PubMed  Google Scholar 

  • Kocher MS, Dicanzio J, Zurakowski D, Micheli LJ (2001) Diagnostic performance of clinical examination and selective magnetic resonance imaging in the evaluation of intraarticular knee disorders in children and adolescents *. Am J Sports Med 29:31–33

    Article  Google Scholar 

  • Kocher MS, Klingele K, Rassman SO (2003b) Meniscal disorders: normal, discoid, and cysts. Orthop Clin North Am 34:329–340

    Article  PubMed  Google Scholar 

  • Kocher MS, Mandiga R, Klingele K et al (2004) Anterior cruciate ligament injury versus tibial spine fracture in the skeletally immature knee: a comparison of skeletal maturation and notch width index. J Pediatr Orthop 24:185–188

    Article  PubMed  Google Scholar 

  • Kocher MS, Shore B, Nasreddine AY, Heyworth BE (2012) Treatment of posterior cruciate ligament injuries in pediatric and adolescent patients. J Pediatr Orthop 32:553–560

    Article  PubMed  Google Scholar 

  • Kocher MS, Logan CA, Kramer DE (2017) Discoid lateral meniscus in children: diagnosis, management, and outcomes. J Am Acad Orthop Surg 25(11):736–743

    Article  PubMed  Google Scholar 

  • Kramer DE, Miller PE, Berrahou IK, Yen Y, Heyworth BE (2017) Collateral ligament knee injuries in pediatric and adolescent athletes. J Pediatr Orthop:1–7. https://doi.org/10.1097/BPO.0000000000001112

  • Laer L v (2001) Frakturen und Luxationen im Kindesalter. Thieme, Stuttgard/New York

    Google Scholar 

  • Major NM, Beard LN Jr, Helms CA (2003) Accuracy of MR imaging of the knee in adolescents. AJR Am J Roentgenol 180:17–19

    Article  PubMed  Google Scholar 

  • Mall NA, Chalmers PN, Moric M, Tanaka MJ, Cole BJ, Bach BR et al (2014) Incidence and trends of anterior cruciate ligament reconstruction in the United States. Am J Sports Med 42:2363–2370

    Article  PubMed  Google Scholar 

  • Min BH, Ha HK, Khang SY (2001) Medial discoid meniscus completely coalesced with the anterior cruciate ligament. Arthroscopy 17(7):E27. https://doi.org/10.1053/jars.2001.23589. PMID: 11536107

    Article  CAS  PubMed  Google Scholar 

  • Pengas IP et al (2012) Total meniscectomy in adolescents: a 40-year follow-up. J Bone Joint Surg Br 94(12):1649–1654

    Article  CAS  PubMed  Google Scholar 

  • Perkins B et al (2018) Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. Knee Surg Sports Traumatol Arthrosc 26(8):2245–2250

    Article  PubMed  Google Scholar 

  • Pinar H, Akseki D, Karaoglan O, Ozkan M, Uluc E (2000) Bilateral discoid medial menisci. Arthroscopy 16:96–101

    Article  CAS  PubMed  Google Scholar 

  • Pisanu G, Moura JL, Sonnery-cottet B (2019) Arthroscopic repair of proximal posterior cruciate. Arthrosc Tech 8:e691–e695

    Article  PubMed  PubMed Central  Google Scholar 

  • Preiss A, Brofhun T, Stietencron I, Frosch K-H (2012) Die vordere Kreuzbandruptur im Wachstumsalter – operativ oder konservativ? Unfallchirurg 115:848–854

    Article  CAS  PubMed  Google Scholar 

  • Pujol N et al (2015) Long-term outcomes of all-inside meniscal repair. Knee Surg Sports Traumatol Arthrosc 23(1):219–224

    Article  PubMed  Google Scholar 

  • Ritter G, Neugebauer H (1989) [Ligament lesions of the knee joint in childhood]. Z Kinderchir 44: 94–96

    Google Scholar 

  • Roach CJ et al (2014) The American Journal of Sports Medicine the epidemiology of medial collateral ligament sprains in young athletes. Am J Sports Med 42:1103–1109

    Article  PubMed  Google Scholar 

  • Rössler R, Junge A, Bizzini M, Verhagen E, Chomiak J, Aus der Fünten K, Meyer T, Dvorak J, Lichtenstein E, Beaudouin F, Faude O (2018) A multinational cluster randomised controlled trial to assess the efficacy of ’11+ Kids’: a warm-up programme to prevent injuries in children’s football. Sports Med 48(6):1493–1504. https://doi.org/10.1007/s40279-017-0834-8. PMID: 29273936; PMCID: PMC5948238

  • Roussignol X et al (2015) Opening the medial tibiofemoral compartment by pie-crusting the superficial medial collateral ligament at its tibial insertion: a cadaver study. Orthop Traumatol Surg Res 101(5):529–533

    Article  CAS  PubMed  Google Scholar 

  • Shea KG, Pfeiffer R, Wang JH, Curtin M, Apel PJ (2004) Anterior cruciate ligament injury in pediatric and adolescent soccer players: an analysis of insurance data. J Pediatr Orthop 24:623–628

    Article  PubMed  Google Scholar 

  • Shea KG, Grimm NL, Ewing CK, Aoki SK (2011) Youth sports anterior cruciate ligament and knee injury epidemiology: who is getting injured? in what sports? when? Clin Sports Med 30(4):691–706

    Article  PubMed  Google Scholar 

  • Shea KG et al (2019) Anatomic dissection and CT imaging of the anterior cruciate and medial collateral ligament footprint anatomy in skeletally immature cadaver knees. J Pediatr Orthop:1–6. https://doi.org/10.1097/BPO.0000000000001398

  • Shieh AK, Edmonds EW, Pennock AT (2016) Revision meniscal surgery in children and adolescents: risk factors and mechanisms for failure and subsequent management. Am J Sports Med 44(4):838–843

    Article  PubMed  Google Scholar 

  • Sonnery-Cottet B, Conteduca J, Thaunat M, Gunepin FX, Seil R (2014) Hidden lesions of the posterior horn of the medial meniscus: a systematic arthroscopic exploration of the concealed portion of the knee. Am J Sports Med 42(4):921–926. https://doi.org/10.1177/0363546514522394. Epub 2014 Feb 24. PMID: 24567252

    Article  PubMed  Google Scholar 

  • Stadelmaier DM, Arnoczky SP, Dodds J et al (1995) The effect of drilling and soft tissue grafting across open growth plates. A histologic study. Am J Sports Med 23:431–435

    Article  CAS  PubMed  Google Scholar 

  • Tachibana Y, Yamazaki Y, Ninomiya S (2003) Discoid medial meniscus. Arthroscopy 19:E12–E18

    Article  PubMed  Google Scholar 

  • Tschauner S et al (2014) The origin points of the knee collateral ligaments: an MRI study on paediatric patients during growth. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-014-2991-8

  • Uchio Y et al (2003) Results of rasping of meniscal tears with and without anterior cruciate ligament injury as evaluated by second-look arthroscopy. Arthroscopy 19(5):463–469

    Article  PubMed  Google Scholar 

  • Valen B, Molster A (1994) Meniscal lesions treated with suture: a follow-up study using survival analysis. Arthroscopy 10:654–658

    Article  CAS  PubMed  Google Scholar 

  • Vanderhave KL et al (2011) Meniscus tears in the young athlete: results of arthroscopic repair. J Pediatr Orthop 31(5):496–500

    Article  PubMed  Google Scholar 

  • Wall EJ, Ghattas PJ, Eismann EA, Myer GD, Carr P (2017) Outcomes and complications after all-epiphyseal anterior cruciate ligament reconstruction in skeletally immature patients. Orthop J Sports Med 5(3):232597117693604. https://doi.org/10.1177/2325967117693604)

    Article  Google Scholar 

  • Watanabe M, Takeda S, Icheuchi H (1979) Atlas of arthroscopy, 3. Aufl. Springer, Berlin/Heidelberg/New York/Tokyo

    Google Scholar 

  • Werner BC, Yang S, Looney AM, Gwathmey FW (2016) Trends in pediatric and adolescent anterior cruciate ligament injury and reconstruction. J Pediatr Orthop 36(5):447–452

    Article  PubMed  Google Scholar 

  • Yang BW, Liotta ES, Paschos N (2019) Outcomes of meniscus repair in children and adolescents. Curr Rev Musculoskelet Med 12:233–238

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yellin JL, Fabricant PD, Gornitzky A, Conrad S, Ganley TJ (2016) Cruciate ligament tears in children. JBJS Rev 4:1–15

    Article  Google Scholar 

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Reuter, P., Stotter, C. (2022). Knieband- und Kniebinnenverletzungen beim Kind. In: Engelhardt, M., Raschke, M. (eds) Orthopädie und Unfallchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54673-0_210-1

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