Arthroscopy of the knee in children

Abstract

The diagnosis of disorders of the knee in children is known to be difficult. Indications of the diagnostic and therapeutic arthroscopy should be carefully evaluated in the childhood period. Arthroscopy was performed in 47 knees of 47 children in our department between the years of June 1985 September 1997. Children were aged 1,5 to 15 years, mean age being 13, 2 years. There were 18 females (38%) and 29 males (62%). Arthroscopic surgical proccedures were carried out due to meniscal and ligamentous lesions (in 17 patients, aged 4-15, mean age 12. 9 years), diagnostic and biopsy for sinovial and intraarticular tumoral lesions (in 17 patients, aged 1.5-15. Mean age 9,8 years), septic arthritis (in 6 patients, aged 4-13, mean age 8.4 years) and anterior knee pain which were refractory to the conservative treatment and chondral lesions (in 7 patients, aged 5-15, mean age 12.3 years). The arthroscopic findings did not always support the clinical diagnosis in meniscal lesions, only 41% of meniscal tears were suspected preoperatively. This study also indicated that in preadolecents, only 60% of preoperative clinical diagnosis were confirmed at surgery. According to results of the histopathology of arthroscopic biopsy materials, there were 6 pigmented villonodular sinovitis, 1 tuberculosis arthritis, 1 osteomyelitis and 2 JRA. We determined symptomatic medial plicae at 6 knees. It is concluded that arthroscopy of the knee in children especially in meniscal lesions and septic arthritis is a safe procedure with high diagnostic and therapeutic value.