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KNEE INJURIES

At Medical City Children’s Orthopedic and Spine Specialist, you and your child have access to see a knee specialist at four convenient locations; Dallas, Frisco, Arlington and McKinney.

“Some things are better treated early while growth potential continues.”

Knee injuries

Child with hurt kneeNo parent wants to see their athletic child sitting on the sidelines, but knee injuries put thousands of young athletes on the bench every year.  So, it’s not unusual for kids to fracture, sprain, strain, or dislocate the kneecap or knee joint.  Especially,  while playing sports, like soccer, or just playing outside with friends.  While most kids just need a few days to recover from a knee injury, severe cases can require surgery.   Unfortunately, surgery will cause a longer recovery before kids are walking, running, and back on the playing field again.

If you suspect your child has a knee injury, it’s important to see a physician as soon as possible.  At Medical City Children’s Orthopedic and Spine Specialists, you have access to a children’s specialist and care right away.  In the event of surgery, children need an orthopedic surgeon who understands the importance of growth plates in growing children.  Our doctors have performed more than 5,900 surgeries and specialize in the treatment of children.

How the Knee Works

To understand how injuries happen, it helps to know how the knee works.  First, the knee is the largest joint in the body, and it provides stability and allows the legs to bend, swivel, and straighten.  The knee joint appears at the ends of the femur (thighbone) and the tibia (shinbone) and the patella (kneecap) provides protection.  Also, the ends of the femur and tibia and the back of the patella are covered in articular cartilage.  This acts as a cushion to keep the femur, patella, and tibia from grinding against each other.  On the top of the tibia, extra pads of cartilage called menisci help absorb the body’s weight.  Furthermore, each knee has two menisci: the inside (medial) meniscus and the outside (lateral) meniscus.

In the knee, there are four strong ligaments called the Anterior and Posterior Cruciate Ligaments (ACL, PCL), and the Medial and Lateral Collateral Ligaments (MCL, LCL).  These ligaments help hold the femur and tibia together.  Also, the muscles around the knee include the quadriceps, a large muscle at the front of the thigh, and the hamstrings, located at the back of the thigh.  For your information, the quadriceps help straightens the leg and the hamstrings help bend the knee.

In addition, several tendons (cables of strong tissue that connect muscles to bones) work together to help move the knee.  For instance, the tendons in the knee are the quadriceps tendon, the patellar tendon, and the hamstring tendons.  To allow the leg to extend, all of these work together.  

Falls and knee Injuries

Falls are the most common cause of non-fatal injuries for children from birth to age 19.  Each day, about 8,000 kids visit emergency rooms due to falls.

Common orthopedic injuries from falls, sports and other physical activities include:

  • Broken bones and dislocations
  • Sprains, strains and tears to muscles, tendons and ligaments
  • Overuse injuries

“Frequent causes of injuries are overuse (from repetitive motions, as in many sports), sudden stops or twists, or direct blows to the knee.” Shyam Kishan, MD

Common Injuries Among Children Include:

Sprains

Knee sprains usually involve damage to the ACL and/or MCL.  Also, the most serious sprains involve complete tears of one or more of the knee ligaments.  Symptoms of knee sprains include:

  • a popping or snapping sound in the knee at the time of injury
  • pain that seems to come from within the knee, especially with movement
  • not being able to bear weight on that leg
  • swelling
  • the knee feels loose or unstable

Strains

When a child partially or completely tears a muscle or tendon, a strain happens.  With knee strains, kids may have bruising around the knee in addition to the symptoms mentioned above for sprains.

Tendonitis

When a tendon is irritated or inflamed, tendonitis happens.  To clarify, it is often caused by overuse or poor training (such as lack of strength exercises or stretching).  For example, a child with tendonitis might have pain or tenderness when walking or at rest, or when bending, extending, or lifting a leg.

Meniscal Cartilage Tears

Especially in sports where kids have sudden changes in speed or make side-to-side movements, damage to the menisci is a very common sports injury.  Further, meniscal injuries can occur together with severe sprains, especially those involving the ACL.  Moreover, meniscal injuries can cause tenderness, tightness, and swelling around the front of the knee, as well as locking of the knee.  Sometimes, fluid collects around the knee (known as effusion).

Fractures and Dislocations

A fracture appears like a cracked, broken, or shattered bone. Children may have trouble moving the bone and are likely to be in a lot of pain.  A Patellar dislocation happens when the patella moves to the side of the knee joint, by twisting or some kind of impact.  Sometimes it will go back to its normal position by itself, but it usually needs to be put back in place by a trained physician.  Symptoms include swelling and pain in the front of the knee, an abnormal bulge on the side of the knee, and an inability to walk on the leg with the affected knee.

Articular Cartilage Injuries

Sometimes a small piece of bone or articular cartilage softens and/or breaks off from the end of a bone, causing long-term knee pain, called osteochondritis dissecans (OCD).  Symptoms include pain, swelling, an inability to move the joint, and stiffness, catching (“locked knee”), or popping sensations with knee movement.  Chondromalacia patellae happen when the cartilage in the patella softens or wears away because of injury, muscle weakness, or overuse, and the patella and the thighbone may rub together.  This causes pain and aching, especially when a person walks upstairs or hills.

Bursitis

A bursa is a sac filled with fluid located over a bony prominence to prevent friction.  If a bursa in the knee becomes irritated and swollen from overuse or constant friction, it can develop into a condition called bursitis. Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of the kneecap.

Osgood-Schlatter Disease

Osgood-Schlatter disease is a painful disorder caused by repetitive stress on the front end of the tibia.  This is where the patellar tendon connects to the bone.  Most common in athletes 10 to 15 years old, its symptoms include a bump below the knee joint that’s painful to the touch.  Pain is relieved with rest, and an aggressive quadricep stretching exercise routine.

Diagnosis

Most knee exams involve lying down flat on a table while the doctor manipulates the knee.  The Doctor will see how stable it appears and observe if any part of the joint hyper-extends or dislocates.  Imaging tests like an MRI, X-ray, or CAT scan might take place to confirm a knee injury and determine its severity.

Our physicians at Medical City Children’s Orthopedic and Spine Specialists have experience and expertise in the treatment of knee fractures. You have access to see a specialist, and should surgery be required, access to an operating room right away. Our board-certified physicians specialize in the treatment of children and adolescents. Give your child the very best care and attention they deserve.

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at
four convenient locations: Arlington, Dallas, Frisco and McKinney.