Journal of Children's Orthopaedics

Osteochondritis dissecans of the knee is an idiopathic, focal, subchondral-bone abnormality that can cause instability or detachment of a bone fragment and overlying articular cartilage, with subsequent progression to osteoarthritis. The degree of lesion instability is best assessed by magnetic resonance imaging. Unstable lesions require operative management with fragment fixation. Level of evidence : V.

PURPOSE: Soccer is a popular sport among children and adolescents that exposes to a high risk of injury. Several prevention programs, including the FIFA 11+ Kids program have been developed to decrease this injury rate. The aim of the study was to investigate the knowledge and use of the FIFA 11+ Kids program among soccer coaches of skeletally immature soccer players in a Swiss canton and analyze difficulties of implementing such a prevention program. MATERIALS & METHODS: First, an online survey was sent to all soccer coaches involved in Swiss training programs for male players from 7 to 13 years of age...

Meniscal pathology is widely prevalent in the adult population, secondary to acute trauma and chronic degeneration. It is less commonly seen in children, although its incidence is rising. The true prevalence in children remains unknown, as pathologies such as discoid menisci often go undiagnosed, or are found only incidentally. The rising incidence can be attributed to increased participation in sports at younger ages, both in intensity and frequency, with potentially year-round competition. Meniscal tears lead to pain and mechanical symptoms in the short to medium term, but more significantly, have been shown to lead to compartmental chondral degeneration and early arthritis in the long term...

BACKGROUND: Patellofemoral instability is a frequent cause of referral in pediatric sports medicine. Isolated medial patellofemoral ligament reconstruction is widely used and provides satisfactory outcomes with a low failure rate. Given the success of this surgical technique, the literature on medial patellofemoral ligament reconstruction failures in the pediatric population is limited. Moreover, given the multifactorial nature of patellofemoral instability, the heterogeneity of the current literature, and the paucity of pediatric studies, medial patellofemoral ligament reconstruction failures are often difficult to analyze...

BACKGROUND: The incidence of meniscal tears in children has been increasing. Early sport specialization, more intense training activity, and increasing participation in competitive sports may have affected to that increasing trend. Diagnosing acute menisci tear in children is based on suggestive clinical and magnetic resonance imaging findings. There are special particulars in immature menisci, due to relatively good vascular supply. Furthermore, growing skeleton makes differences in injury pattern, and a clinician needs to recognize not only meniscus but also potential injuries in growth plates and ligaments, which are usual in connection with pediatric meniscus leasion...

BACKGROUND: Osteochondritis dissecans is an acquired condition of the joint that affects the articular surface and the subchondral bone. The juvenile form of osteochondritis dissecans presents in those aged 5-16 years with open growth plates. The causes of osteochondritis dissecans are unknown. METHODS: The goals of treatment are to promote healing of the subchondral bone and prevent chondral collapse, subsequent fracture, osteochondral defect formation, and early joint degeneration...

The incidence of anterior cruciate ligament injuries in skeletally immature patients has increased in recent years. The gold standard treatment of this type of trauma in children is not yet established. Conservative management may underestimate the risk of new meniscal and chondral tears; on the other hand, a more interventional approach may expose the patient to iatrogenic damage to the growth plate. A correct approach to the skeletally immature patient with knee trauma is therefore essential to guide the decision-making process...

BACKGROUND: Lateral dislocation of the patella is a common injury in children. It can occur in previously healthy and anatomically normal knees, but there are several abnormalities that predispose to patellar instability. Magnetic resonance imaging is an essential part of assessing for associated injuries and risk of further instability. Treatment aims to prevent redislocation, residual instability, osteoarthritis, and allow return to previous activities. The purpose of this review was to assess evidence for management of first-time patella dislocation in children and adolescents...

No abstract text is available yet for this article.

BACKGROUND: Anterior cruciate ligament injury in the child and adolescent patient remains a controversial topic when considering management, especially regarding surgical choices. Treatment variations are seen not just when comparing different countries but also within nations. This arises partly as contemporary treatment is mostly inferred from the adult population who physiologically and in terms of outcomes differ significantly from children. There is an increasing body of evidence for this cohort of patients who have specific challenges and difficulties when determining the optimum treatment...

Osteochondritis dissecans of the knee is a disease that typically affects skeletally immature patients. Clinically manifested with knee pain, limping, and joint disfunction, this condition has remained misunderstood and undervalued for a long period. Although being a rare condition, its awareness is of utmost clinical interest because of the possible severe consequences it can bring when misrecognized or inadequately treated. Its etiology remains unclear and is still debated. Many theories have been proposed, including inflammation, local ischemia, subchondral ossification abnormalities, genetic factors, and repetitive mechanical microtrauma, with a likely interplay of the same...

No abstract text is available yet for this article.

BACKGROUND: Displaced medial epicondyle fractures are treated with open reduction and internal fixation with K-wires or screws. Rates of implant prominence, failure, or non-union reported are considerable. Magnesium screws have demonstrated biocompatibility, osteoconductivity, and high pull-out strength. The aim of this study was to compare surgical fixation of medial epicondyle fracture using resorbable magnesium Herbert screws to K-wires, in skeletally immature patients. METHODS: A retrospective analysis was performed from January 2015 to April 2020...

PURPOSE: Pinning of pediatric elbow fractures has been shown to be a safe procedure with a low complication profile. This study identified patients who underwent cartilage surgery for elbow osteochondral lesions or osteochondritis dissecans who had prior ipsilateral elbow pinning. METHODS: Records of patients who underwent ipsilateral cartilage surgery for osteochondritis dissecans and prior percutaneous pinning for elbow fractures were identified. Demographics were compiled and the clinical, radiographic, and surgical results were tabulated for patients with at least 1-year of follow-up from initial presentation...

PURPOSE: The purpose of this study is to compare pediatric hip aspiration in the operating room under general anesthesia or via bedside aspiration under moderate sedation and delineate the anesthetic time required. METHODS: A database query conducted at two academic institutions identified all patients under the age of 17 who underwent hip aspiration between 2000 and 2017. At one institution, aspiration was performed in the operating room under general anesthesia...

No abstract text is available yet for this article.

INTRODUCTION: Pediatric back pain evaluation nowadays relies on patient history, physical examination, and plain radiographs to identify underlying pathologies. Constant pain, night pain, radicular pain, and abnormal neurological examination were previously recommended as clinical markers to assess the need for magnetic resonance imaging evaluation. Recent studies have challenged the use of these clinical markers, recommending further studies. This study aimed to assess pain intensity as a predictor of underlying magnetic resonance imaging pathology in children with back pain...

PURPOSE: We present the paraspinal approach use for neuromuscular scoliosis with focus on deformity correction, perioperative (≤30 days) morbidity and outcome at a minimal follow-up length of 2 years. METHODS: We prospectively collected data of 61 neuromuscular scoliosis patients operated using a paraspinal (Wiltse) approach between 2013 and 2019. We additionally collected data of 104 control cases, operated using a midline approach between 2005 and 2016...

No abstract text is available yet for this article.

PURPOSE: Physician review websites are a heavily utilized patient tool for finding, rating, and reviewing surgeons. Natural language processing such as sentiment analysis provides a comprehensive approach to better understand the nuances of patient perception. This study utilizes sentiment analysis to examine how specific patient sentiments correspond to positive and negative experiences in online reviews of pediatric orthopedic surgeons. METHODS: The online written reviews and star ratings of pediatric surgeons belonging to the Pediatric Orthopaedic Society of North America were obtained from healthgrades...