Meniscal Tears in Children

Meniscal tears in children are less common than in adults and usually occur due to either a discoid meniscus (congenital variant) or trauma.

Discoid meniscus

A discoid meniscus is a congenital condition in which the meniscus is abnormally shaped and thicker than normal. This makes it prone to catching and tearing.

Symptoms

  • Clicking or clunking in the knee
  • Intermittent locking, sometimes even during sleep
  • Difficulty straightening the knee from a bent position
  • Activity-related pain

Investigations

  • MRI scan is diagnostic and confirms the shape and any tear

Treatment

Non-operative management

  • Physiotherapy to improve strength and control
  • May provide temporary relief but symptoms often recur

Surgical Treatment

Indicated for painful clicking or recurrent locking.

  • Arthroscopic (keyhole) reshaping and repair of the meniscus
  • Usually performed as a day-case procedure

After Surgery

  • Walking allowed with crutches
  • Early range-of-motion exercises encouraged
  • Physiotherapy required for gradual rehabilitation

Traumatic Meniscal Tears

Less common in children and frequently associated with other injuries, particularly ACL tears.

Investigations

  • MRI scan to diagnose the tear and identify associated ligament injuries

Treatment

Management is planned according to associated injuries and typically includes repair of the meniscus along with treatment of the accompanying ligament damage.

Preserving the meniscus is especially important in children to prevent early joint degeneration.

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