Adolescent Knee

Plymouth Orthopaedic and Sports Injury Clinic

It needs to be borne in mind that children and adolescents may complain of knee pain when the hip joint is the true source of the problem. Malignant tumours around the knee are fortunately extremely rare, but any child with persistent constant pain, particularly night pain needs to be investigated.

Jumpers Knee causes pain at the bottom of the patellar tendon, and is usually seen in athletic children around puberty. It is almost always self limiting but can leave a classic knobbly knee, technically called Osgood Sclatters “Disease”. Usually no treatment is required.

Osteochondritis Dissecans presents after puberty, often with relatively intermittent knee pain. It is probably caused by a temporary interruption in blood supply to a small area of bone underlying the joint surface. It may not be apparent on plain Xrays, but MRI scanning will clinch the diagnosis. This may resolve with a period of modified activity, but occasionally requires surgery. Sometimes in later teenage years or early adult life, the fragment can become loose and displaced into the knee joint forming a loose body.

Pain behind the knee cap is very common in teenage girls. It is referred to by a number of names including Anterior Knee Pain and Chondromalacia Patella. Patello_Femoral pain is perhaps the best term. Frequently no specific cause can be identified, but occasionally variations in the way the leg has developed cause abnormal loading of the patellofemoral joint. In most cases, this problem can be managed without surgery, with physiotherapy playing a useful role.

Patella Dislocation is often provoked by a sporting event. Frequently there is a subtle underlying variation in the normal anatomy (for example a slightly high patella due to a long patellar tendon) which makes this more likely. Initial treatment involves physiotherapy supervised rehab, but surgery is indicated if this becomes a recurrent problem.