The paediatric knee: Traumatic injuries

The 40th Annual meeting of the European Paediatric Orthopaedic Society (EPOS) was held in Copenhagen on 6–9 April 2022. A pre-meeting course on The Pediatric Knee—Traumatic Injuries was successfully conducted on 6 April. The course featured a comprehensive breakdown of current knowledge and state-of-the-art treatment. The manuscripts in this special issue of the Journal of Children’s Orthopaedics have been developed from the talks presented at the pre-meeting course. The intention is that this special issue should collect the latest evidence from an advancing and growing problem for orthopedic surgeons treating children; traumatic injuries of the knee in children. Children who present with knee lesions may more often require specific surgical management compared to adults. Due to earlier and more intensive participation in sports activities, a growing number of acute and overuse knee injuries are being treated today.

The course consisted of five sessions to cover all aspects of traumatic knee injuries in children. We sincerely thank the authors for their dedication to this subject. Participation in the pre-meeting course was excellent.

In the first part of the course, patello-femoral instability in children was broken down in smaller topics by the faculty. This topic is important for a broader range of orthopaedic surgeons as mechanical axis deviation or rotational deformities can play a major role in patello-femoral instability. We learned about correct imaging, treatment strategies, and surgical techniques. This issue includes two papers on patello-femoral instability that have been synthesized based on the course.

Osteochondritis dissecans was the next subject in the course. The panel gave talks on this important topic including etiology and epidemiology as well as imaging and instability criteria. Treatment strategies for the most common site (the medial femoral condyle) and the remaining parts of the knee were discussed. We also had a presentation with results from the ROCK Study Group (international study group). Based on this session, three papers have been included in this special issue.

Sessions 3 and 4 were used to discuss anterior cruciate ligament (ACL) injuries in the growing child. This area is attracting special interest because the number of both injuries and surgical treatments are increasing. Special focus was given to different treatment strategies and surgical techniques were discussed. Injury prevention is very important for young athletes, and we have included a paper on this subject as well as two additional papers on ACL injuries in children.

The final session investigated meniscal injuries in children. Previously, this was believed to be less common injuries mainly attributed to discoid meniscus. Even though still contributing substantially to this subject, traumatic injuries are now more frequent in the normal menisci either as isolated lesions or as part of ligamentous injuries. In children it is crucial to avoid resection and improved surgical technique and implants have made it possible to minimize loss of meniscal tissue in a modern setting.

We send our warmest thanks to the EPOS board and the organizing committee that made this pre-meeting course happen. The faculty has been enthusiastic and the combined work with presentations and the manuscripts for this fantastic issue is highly valued.

Martin Gottliebsen
Orthopaedics, Aarhus University Hospital, Aarhus, Denmark

Marco Turati
Orthopedic Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy