Knee Pain in Children – Who Should You See?

Dave Duffy looks at an ongoing debate about who should treat your child’s knee injury in specific circumstances.

Why are more young people suffering knee injuries?

Ask any knee surgeon and they’ll tell you they’re seeing many more instances of children and young people with sporting knee injuries you’d more commonly associate with adults. We think we know why this is happening. As more young people are talent spotted early and siphoned to specific, elite football/rugby/netball/athletics training programmes, so they spend a lot more time training at a higher intensity, placing the same stress forces through the same muscles and ligaments in the same way.

The shift over the last couple of decades from multi-sports—where different muscle groups and ligaments are tested in different ways—to single sports appears to have increased the risk and frequency of injury. It’s also fair to say that GPs, emergency doctors and physiotherapists have all become more familiar with identifying these injuries earlier.

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Which knee surgeon?

The increase in young and adolescent knee injuries has led to a debate among surgeons worldwide: who should treat them? Should it be a knee surgeon who spends their day doing nothing but knee surgery but may not work frequently with children? Or should it be paediatric orthopaedic surgeons who do nothing but treat young people, but who may not conduct a great deal of knee surgery? (There is a third category of knee surgeon to throw into this mix—the paediatric knee surgeon—but numbers are currently small).

My view on this is that it depends on the nature of the condition or injury.

For children with a generalised knee condition—one that they’ve been born with or which occurs as a result of childhood development—it would seem the paediatric consultants would be best placed to treat. For children with adult-type injuries such as ACL and meniscal tears—the sort of sporting injuries we’re seeing in growing numbers—it seems to me that the surgeons best placed to treat are those who see more of those injuries: the established knee surgeons.

If this seems like an academic question, or an internal squabble between one area of clinical treatment and another, it’s not. It’s a matter of experience, specialism and risk in a patient group where even small improvements could make a profound difference.

> Discover more about children’s knee pain & injuries

Why surgeon choice matters

We know, for example, that in the case of an ACL injury, the highest risk of re-injury or failure (of the ACL reconstruction) occurs in the youngest patients. If you’re under 18 and have torn your ACL, you have a 25% risk of reinjuring either leg. With a risk of reinjury that high, we should examine every possible opportunity to reduce that risk, no matter how small. That’s why the question of who should treat them assumes real importance.

Yorkshire Knee Clinic knee surgeons treat large numbers of sporting knee injuries, many of them in children and adolescents. To talk to us about your child’s knee injury, please contact us or phone us on 03453 052 579.

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