CONGENITAL AND ACQUIRED CHANGES OF THE KN EE-JOINT MENISCI IN CHILDREN

Children with congenital and acquired pathology of the menisci account for 7.2% of all patients with internal pathological conditions of the knee joint. The clinical manifestations are due to instability of the joint. In rupture of normally developed menisci the instability is ac ute or subacute and is displayed by general unspecific reactive sympto matology. The clinical signs of instability are revealed in children w ith anomalous development of the menisci due to decompensation of the defence-adaptational mechanisms and are evidence of a chronic patholog ical condition. A precise topical diagnosis of pathology of the menisc i may be established only by means of special examination methods amon g which arthropneumography plays the principal role. The studies made it possible to distinguish and describe a previously unknown pathologi cal condition-abnormal attachment of the menisci to the transverse lig ament of the knee. Paracapsular resection of the ruptured or discoid m eniscus through a wide parapatellar approach is the optimal surgical p olicy. Rational postoperative management consisting in early and prolo nged kinesitherapy with exclusion of an axial load on the limb and a s ystem of active medical follow-up restore the stability of the knee jo int and its full function in 95% of patients and maintain it for posto perative periods of up to 10 years.