Torn Cartilage in Knees in Children

Ligament injuries and torn cartilage can cause children knee pain. If pain is severe or persists for more than a few days, contact your child's pediatrician. Have your child checked if he cannot walk, straighten his leg or put weight on the knee. Watch for swelling and redness around the knee. Rest, putting ice on the area and giving your child acetaminophen or ibuprofen will usually help relieve the pain, but a torn ligament or cartilage may require surgery to repair.

ACL Injury

• A torn anterior cruciate ligament (ACL) is a common sports injury among children. The ACL is one of the ligaments in the knee connecting the tibia to the femur. Suddenly stopping or twisting the knee with the foot planted on the ground can cause an overstretched ACL to tear. A direct blow to the knee during roughhousing or a football tackle can also cause a torn ACL. The child may hear a pop or crack at the time of injury.

Diagnosis

• The doctor will start with a physical examination of the knee when looking for an ACL tear. When diagnosing ACL injury, a doctor will evaluate any looseness in the knee joint. Magnetic Resonance Imaging (MRI) is a diagnostic tool that can show damage to the knee, particularly the meniscus, which is the cartilage inside the knee. Many times injury to the ACL also involves tearing of the meniscus.

Treatment

• Apply ice to the area immediately after the injury to help reduce swelling. Elevating the knee can reduce swelling as well. Physical therapy may be necessary to increase a child's range of motion and improve muscle strength. Improving range of motion prevents the knee muscles from becoming stiff. Once swelling around the knee goes down, weight-bearing exercises can be added to the child's rehab program.

Surgery

• Surgery to reconstruct the torn ligament is not always necessary. The decision to operate may be based on several different factors, including the child's age. An important point the orthopedic surgeon must consider is that a child is still growing. There is the risk that the normal development of the child's bones may be damaged during surgery, as the growth plate is located near the knee joint.

  Unless a child is involved in sports or is extremely active, reconstructive surgery involves many months of rehabilitation afterward. However, a child is more likely than an older adult to stick to a rigid rehabilitation program following surgery. Surgery involves either repairing the torn ACL or substituting the damaged knee ligament with a tendon taken from another part of the body, in which case the ligament must be reattached to the bone.

Girl Athletes

• According to doctors at the Sports Medicine Center at Akron Children's Hospital, the incidence of ACL injuries continues to rise in young female athletes. One reason for this may be intense training programs for girls competing in school sports. The female anatomy may also increase a young girl's risk of tearing the ACL. A notch in the femur where the ACL is located is narrower in girls than it is in boys. In addition, females have a wider pelvis, which causes the thighs to slant more inward, putting additional strain on the knees. Female hormones play a part, too, as girls are more prone to ACL injury during certain times in their menstrual cycles. Aside from the effects of estrogen on ligament growth, females have less testosterone, the hormone that stimulates tissue repair.