Ouch! Traumatic Knee Injuries in Kids

Acute injuries vary from sport to sport, but the lower extremity (the knee in particular) is one of the most common joints injured in the young and older athlete.

So, you're watching your teenage daughter play basketball and all of the sudden she goes down in pain clutching her knee.  What happens next?  If your child is high school age, most commonly there is a trainer on the sideline that can quickly evaluate the injury, but if not, it's important to seek medical attention (or call your pediatrician for advice).  Few knee injuries necessitate a trip to the ER, but it is wise to talk to a medical professional if your child has an acute knee injury.

Swelling in the knee joint is never normal in kids and shouldn't be ignored.  There are only a few things that can cause swelling in children when they injure their knee (broken bones and torn ligaments are the most common in kids), and each of those causes need further evaluation and treatment.

The ACL (one of the 4 ligaments in the knee) gets a lot of attention thanks to Sportscenter - but it is actually one of the more common traumatic knee injuries in adolescents.  It can happen before adolescents, but it is rare because young children still have open growth plates.  Females are more prone to tear their ACL and it is most common in cutting/pivoting sports like basketball, soccer, and football.  Rarely does someone tear their ACL from colliding with another player - the injury usually occurs on a landing or turn/pivot.

Is it always necessary to get an MRI?  In short, no.  Most traumatic knee injuries can easily be diagnosed by the physical exam.  However, an MRI helps assess any other injuries that may be present and also helps prepare for surgery if necessary.

What knee injuries in kids need an operation?  ACL repair is necessary after tearing the ligament, because you can't cut or pivot without it.  Other traumatic injuries that may need an operation are meniscus injuries (the cartilage in your knee) or severe knee cap dislocations.  However, every child is different and some of these injuries do well with physical therapy and other treatments, so surgery can be avoided.

Just like in adults, some of these injuries can be prevented if your child maintains their flexibility and strength in their core and lower extremities.  For instance, their are specific ACL prevention programs that exist (especially for females), which include things like quad and hamstring strength and proper technique for landing and cutting/pivoting.

Your child can definitely get back to playing his or her sport after a traumatic knee injury, but it is important to understand what the cause of the injury is and get it treated appropriately!

Rachel Brewer, MD