Knee arthroscopy in children

Purpose of the study Between 1990 and 1998, 110 knee arthroscopies were per formed in children. We analyzed the epidemiology and diagnostic data and st udied the correlation between clinical and radiographic findings and the fi nal diagnosis after arthroscopy in order to establish a consensus on use of knee arthroscopy in children. Material and methods We made a retrospective analysis of 110 knee arthrosco pies performed in children, classing the patients in three age groups: 0-5 years, 5-10 years, 10-17 years. Clinical and radiological findings were com pared with the arthroscopy findings. Results One or more arthroscopies were performed in 56 boys and 48 girls. M ean age at the time of the procedure was 12 years 4 months. There were 11 c hildren aged 0-5 years, 14 aged 5-10 years and 85 aged 10-17 years. The mai n pathology was arthritis in the 0-5 year and 5-10 year age groups. Trauma was more frequent in the older children. Knee arthroscopy was found to be n ormal in 19 cases. Discussion For most surgery teams, arthroscopy is indicated for arthritis o f the knee. Arthroscopy may also be needed for hemarthrosis. In these conte xts, arthroscopy is both a diagnostic and therapeutic procedure. Our analys is demonstrates that emergency arthroscopy is only warranted for free float ing osteochondral fractures and fractures of the tibial articular surfaces, with the exception of the tibial spines. Arthroscopy may be performed late r in other cases after careful physical examination and radiographic series . We had 19 normal arthroscopies and 10 that showed femoropatellar chondrop athies and plicas that could explain knee pain. We recommend arthrography b efore arthroscopy to avoid unnecessary procedures. Conclusion Arthritis of the knee is an excellent indication for arthroscopy . Painful and acute hemarthrosis requires attentive physical exams and x-ra ys before making the decision for surgery.