Both Osgood-Schlatter\ndisease and Sinding-Larsen-Johansson syndrome are typical overuse syndromes that\noccur in highly active children, usually ages 10 to 14 years. The reason is apophysitis\n(irritation and partial collapse of the growth plate) on the respective end of\nthe patella tendon. The muscles straightening the knee are strong, and those\nforces are transferred to the tibia (shin bone) over the patella (kneecap) and\nthe patellar tendon (tendon between the kneecap and the shin bone).<\/p>\n\n\n\n
Osgood-Schlatter\ndisease affects the tendon insertion at the tibia (shin bone), and\nSinding-Larsen-Johansson syndrome affects the tendon insertion on the lower tip\nof the patella (kneecap). <\/p>\n\n\n\n
Pain usually starts\nduring sports or in early stages after sports. The pain is activity-related,\nand children often complain when climbing stairs. In most cases, the pain can\nbe well localized. Diagnosis is based on physical examination and tender\npoints.<\/p>\n\n\n\n
Rest and a cool pack\nor ice pack can help to eliminate pain. Physical therapy, stretching exercises,\nand activity modification are recommended to minimize symptoms. Symptoms almost\nalways stop at the end of growth, but they can be persistent until then,\nespecially when sports activities are continued. <\/p>\n\n\n\n
Jumper’s knee (patellar\ntendonitis) must be differentiated from Osgood-Schlatter disease and\nSinding-Larsen-Johansson syndrome. With Jumper\u2019s knee, the patellar tendon\nitself is inflamed or injured from overuse. Pain is typically localized at the\ntendon below the kneecap. This disorder can also be found in adults. <\/p>\n\n\n\n
Many of these overuse\nsyndromes can be prevented by a good warm-up regimen that includes stretching\nand by stretching after exercise. <\/p>\n\n\n\n
![\"Osgood](\"https:\/\/radler-ortho.com\/wp-content\/uploads\/2020\/06\/osgood-schlatter-sinding-larsen-johannson-syndrome-.jpg\")
<\/figure><\/div>\n\n\n\nOsteochondritis Dissecans<\/strong><\/h2>\n\n\n\nOsteochondritis dissecans\nis most likely caused by repetitive microtrauma and decreased bone blood\nsupply. The subchondral bone is affected and separates the cartilage from the\nrest of the bone. As a result, the cartilage can get partially or completely\nseparated and the fragment can detach and form a loose body within the joint.\nPain can be mild and nonspecific and is usually related to activity. The area\nmostly affected is the medial (inner) part of the femur (thigh bone).<\/p>\n\n\n\n
Early-stage lesions in\nyoung children can heal spontaneously with rest and activity modification. In\nmore advanced stages, arthroscopy and drilling through the subchondral bone\nlamina can increase the healing rate. In cases with partial detachment,\nrefixation with self-absorbing pins can be necessary. When the cartilage has\ndetached completely, the lesion needs to be stabilized and covered with\nsynthetic tissue or cultivated cartilage tissue. <\/p>\n\n\n\n
Axial Malalignment and Torsional Malalignment <\/strong><\/h2>\n\n\n\nAxial malalignment (bowlegs and knock-knees) or torsional (rotational)\nproblems (in-toeing or out-toeing) of the lower limbs are common abnormalities that\ncan easily be detected by observing the gait pattern. If the malalignments are\nsymmetrical, they are usually idiopathic deformities (of no specific cause). Malunited\n(incorrectly healed) fractures and injuries with which the growth plate has\nbeen damaged can also lead to axial and\/or torsional malalignment. <\/p>\n\n\n\n
Patella-Femoral Dislocations and Ligament and Meniscal Injuries <\/strong><\/h2>\n\n\n\nThe patella (kneecap) sits\nin the trochlear groove of the femur (thigh bone) and is fixed on the sides\nwith ligaments. If the kneecap leaves the groove, we speak of a patella\ndislocation. <\/p>\n\n\n\n
Patella dislocation\ncan occur with trauma, sometimes in the presence of predisposing factors. If the\npredisposing factors are substantial, the patella can dislocate with minimal\ntrauma or \u201chabitually\u201d on its own without any traumatic event. <\/p>\n\n\n\n
In cases of first-time\ntraumatic dislocations, physical therapy is often enough to provide correction.\nIn other cases, especially in cases of repeated dislocation, soft tissue\nsurgery with reconstruction of the ligament that stabilizes the patella (medial\npatellofemoral ligament [MPFL] reconstruction) or displacement of tendons might\nbe necessary to enable a central and stable position of the patella. In certain\ncases, predisposing factors, such as knock-knees, torsional malalignment, or a\nshallow trochlear groove, must also be addressed. \n\nFortunately, damage to the meniscus or cruciate\nligaments is exceedingly rare in children. However, such injury patterns can be\nfound in professional and semi-professional young athletes and require age-appropriate\ntreatment taking into account residual growth.\n\n\n\n<\/p>\n","protected":false},"excerpt":{"rendered":"
When children complain about pain in the knee, obtaining a detailed history is necessary. The complaints are often diffuse, and it is difficult to determine whether the source of pain is the knee itself or the hip. Pain at rest must be differentiated from pain with activity and from pain after activity. Typical knee problems … Continue reading Knee<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":19,"menu_order":6,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"translation":{"provider":"WPGlobus","version":"2.12.2","language":"en","enabled_languages":["de","en"],"languages":{"de":{"title":true,"content":true,"excerpt":false},"en":{"title":true,"content":true,"excerpt":false}}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/pages\/294"}],"collection":[{"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/comments?post=294"}],"version-history":[{"count":26,"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/pages\/294\/revisions"}],"predecessor-version":[{"id":1267,"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/pages\/294\/revisions\/1267"}],"up":[{"embeddable":true,"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/pages\/19"}],"wp:attachment":[{"href":"https:\/\/radler-ortho.com\/en\/wp-json\/wp\/v2\/media?parent=294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Axial malalignment (bowlegs and knock-knees) or torsional (rotational)\nproblems (in-toeing or out-toeing) of the lower limbs are common abnormalities that\ncan easily be detected by observing the gait pattern. If the malalignments are\nsymmetrical, they are usually idiopathic deformities (of no specific cause). Malunited\n(incorrectly healed) fractures and injuries with which the growth plate has\nbeen damaged can also lead to axial and\/or torsional malalignment. <\/p>\n\n\n\n