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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2017

27.05.2016 | Knee

Meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures

verfasst von: Matthias J. Feucht, Peter U. Brucker, Carlo Camathias, Karl-Heinz Frosch, Michael T. Hirschmann, Stephan Lorenz, Hermann O. Mayr, Philipp Minzlaff, Wolf Petersen, Tim Saier, Dorien Schneidmüller, Amelie Stoehr, Daniel Wagner, Norbert P. Südkamp, Philipp Niemeyer

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 2/2017

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Abstract

Purpose

To prospectively evaluate the prevalence and characteristics of meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures and to test for possible relationships between associated meniscal lesions and patient demographics or injury characteristics.

Methods

A prospective multicenter study was conducted to arthroscopically assess the prevalence and characteristics of meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures between 04/2014 and 10/2015. Patient demographics and injury characteristics were assessed preoperatively. The presence of a meniscal injury was evaluated arthroscopically and characterized according to tear type and location (Cooper classification). Patients with and without meniscal injuries were compared with regard to sex, age, height, weight, BMI, type of injury, mechanism of injury, time to surgery, Tanner stage, sexual maturity (prepubescent vs. pubescent), and modified Meyers and McKeever classification.

Results

A total of 54 consecutive patients (65 % males, mean age: 12.5 ± 3.2 years) were enrolled. Meniscal injury were found in 20 patients (37 %). The lateral meniscus was involved in 18 patients (90 % of all meniscus injuries) and the medial meniscus in 2 patients (10 % of all meniscus injuries). The most common tear pattern was a longitudinal tear of the posterior horn of the lateral meniscus (30 % of all meniscus injuries) and the second most common tear was a root detachment of the anterior horn of the lateral meniscus (20 % of all meniscus injuries). Higher age, advanced Tanner stage, and pubescence were significantly associated with an accompanying meniscal injury.

Conclusion

Meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures must be expected in almost 40 %, with a higher prevalence with increasing age and sexual maturity. With regard to the clinical relevance, the results of the present study argue in favor for magnetic resonance imaging prior to surgery in every patient with a suspected tibial eminence fracture and for an arthroscopic approach to adequately diagnose and treat meniscal injuries.

Level of evidence

II.
Literatur
1.
Zurück zum Zitat Ahn JH, Yoo JC (2005) Clinical outcome of arthroscopic reduction and suture for displaced acute and chronic tibial spine fractures. Knee Surg Sports Traumatol Arthrosc 13(2):116–121CrossRefPubMed Ahn JH, Yoo JC (2005) Clinical outcome of arthroscopic reduction and suture for displaced acute and chronic tibial spine fractures. Knee Surg Sports Traumatol Arthrosc 13(2):116–121CrossRefPubMed
2.
Zurück zum Zitat Anderson AF, Anderson CN (2015) Correlation of meniscal and articular cartilage injuries in children and adolescents with timing of anterior cruciate ligament reconstruction. Am J Sports Med 43(2):275–281CrossRefPubMed Anderson AF, Anderson CN (2015) Correlation of meniscal and articular cartilage injuries in children and adolescents with timing of anterior cruciate ligament reconstruction. Am J Sports Med 43(2):275–281CrossRefPubMed
3.
Zurück zum Zitat Bogunovic L, Tarabichi M, Harris D, Wright R (2015) Treatment of tibial eminence fractures: a systematic review. J Knee Surg 28(3):255–262CrossRefPubMed Bogunovic L, Tarabichi M, Harris D, Wright R (2015) Treatment of tibial eminence fractures: a systematic review. J Knee Surg 28(3):255–262CrossRefPubMed
4.
Zurück zum Zitat Brunner S, Vavken P, Kilger R, Vavken J, Rutz E, Brunner R, Camathias C (2016) Absorbable and non-absorbable suture fixation results in similar outcomes for tibial eminence fractures in children and adolescents. Knee Surg Sports Traumatol Arthrosc 24(3):723–729CrossRefPubMed Brunner S, Vavken P, Kilger R, Vavken J, Rutz E, Brunner R, Camathias C (2016) Absorbable and non-absorbable suture fixation results in similar outcomes for tibial eminence fractures in children and adolescents. Knee Surg Sports Traumatol Arthrosc 24(3):723–729CrossRefPubMed
5.
Zurück zum Zitat Chotel F, Raux S, Accadbled F, Gouron R, Pfirrmann C, Berard J, Seil R (2016) Cartilaginous tibial eminence fractures in children: Which recommendations for management of this new entity? Knee Surg Sports Traumatol Arthrosc 24(3):688–696CrossRefPubMed Chotel F, Raux S, Accadbled F, Gouron R, Pfirrmann C, Berard J, Seil R (2016) Cartilaginous tibial eminence fractures in children: Which recommendations for management of this new entity? Knee Surg Sports Traumatol Arthrosc 24(3):688–696CrossRefPubMed
6.
Zurück zum Zitat Cooper DE, Arnoczky SP, Warren RF (1991) Meniscal repair. Clin Sports Med 10(3):529–548PubMed Cooper DE, Arnoczky SP, Warren RF (1991) Meniscal repair. Clin Sports Med 10(3):529–548PubMed
7.
Zurück zum Zitat Coyle C, Jagernauth S, Ramachandran M (2014) Tibial eminence fractures in the paediatric population: a systematic review. J Child Orthop 8(2):149–159CrossRefPubMedPubMedCentral Coyle C, Jagernauth S, Ramachandran M (2014) Tibial eminence fractures in the paediatric population: a systematic review. J Child Orthop 8(2):149–159CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Dumont GD, Hogue GD, Padalecki JR, Okoro N, Wilson PL (2012) Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: relationship of treatment time and patient-specific factors. Am J Sports Med 40(9):2128–2133CrossRefPubMed Dumont GD, Hogue GD, Padalecki JR, Okoro N, Wilson PL (2012) Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: relationship of treatment time and patient-specific factors. Am J Sports Med 40(9):2128–2133CrossRefPubMed
9.
Zurück zum Zitat Dunn WR, Wolf BR, Amendola A, Andrish JT, Kaeding C, Marx RG, McCarty EC, Parker RD, Wright RW, Spindler KP (2004) Multirater agreement of arthroscopic meniscal lesions. Am J Sports Med 32(8):1937–1940PubMed Dunn WR, Wolf BR, Amendola A, Andrish JT, Kaeding C, Marx RG, McCarty EC, Parker RD, Wright RW, Spindler KP (2004) Multirater agreement of arthroscopic meniscal lesions. Am J Sports Med 32(8):1937–1940PubMed
10.
Zurück zum Zitat Edmonds EW, Fornari ED, Dashe J, Roocroft JH, King MM, Pennock AT (2015) Results of displaced pediatric tibial spine fractures: a comparison between open, arthroscopic, and closed management. J Pediatr Orthop 35(7):651–656CrossRefPubMed Edmonds EW, Fornari ED, Dashe J, Roocroft JH, King MM, Pennock AT (2015) Results of displaced pediatric tibial spine fractures: a comparison between open, arthroscopic, and closed management. J Pediatr Orthop 35(7):651–656CrossRefPubMed
11.
Zurück zum Zitat Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Sudkamp NP, Niemeyer P (2015) Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res 10:34CrossRefPubMedPubMedCentral Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Sudkamp NP, Niemeyer P (2015) Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res 10:34CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Feucht MJ, Minzlaff P, Saier T, Lenich A, Imhoff AB, Hinterwimmer S (2015) Avulsion of the anterior medial meniscus root: case report and surgical technique. Knee Surg Sports Traumatol Arthrosc 23(1):146–151CrossRefPubMed Feucht MJ, Minzlaff P, Saier T, Lenich A, Imhoff AB, Hinterwimmer S (2015) Avulsion of the anterior medial meniscus root: case report and surgical technique. Knee Surg Sports Traumatol Arthrosc 23(1):146–151CrossRefPubMed
13.
Zurück zum Zitat Feucht MJ, Salzmann GM, Bode G, Pestka JM, Kuhle J, Sudkamp NP, Niemeyer P (2015) Posterior root tears of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 23(1):119–125CrossRefPubMed Feucht MJ, Salzmann GM, Bode G, Pestka JM, Kuhle J, Sudkamp NP, Niemeyer P (2015) Posterior root tears of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 23(1):119–125CrossRefPubMed
14.
Zurück zum Zitat Gans I, Baldwin KD, Ganley TJ (2013) Treatment and management outcomes of tibial eminence fractures in pediatric patients: a systematic review. Am J Sports Med 42(7):1743–1750CrossRefPubMed Gans I, Baldwin KD, Ganley TJ (2013) Treatment and management outcomes of tibial eminence fractures in pediatric patients: a systematic review. Am J Sports Med 42(7):1743–1750CrossRefPubMed
15.
Zurück zum Zitat Hewett TE, Shultz SJ, Griffin LY (2007) Understanding and preventing noncontact ACL injuries. Human Kinetics, Champaign, pp 166–167 Hewett TE, Shultz SJ, Griffin LY (2007) Understanding and preventing noncontact ACL injuries. Human Kinetics, Champaign, pp 166–167
16.
Zurück zum Zitat Hirschmann MT, Mayer RR, Kentsch A, Friederich NF (2009) Physeal sparing arthroscopic fixation of displaced tibial eminence fractures: a new surgical technique. Knee Surg Sports Traumatol Arthrosc 17(7):741–747CrossRefPubMed Hirschmann MT, Mayer RR, Kentsch A, Friederich NF (2009) Physeal sparing arthroscopic fixation of displaced tibial eminence fractures: a new surgical technique. Knee Surg Sports Traumatol Arthrosc 17(7):741–747CrossRefPubMed
17.
Zurück zum Zitat Ishibashi Y, Tsuda E, Sasaki T, Toh S (2005) Magnetic resonance imaging AIDS in detecting concomitant injuries in patients with tibial spine fractures. Clin Orthop Relat Res 434:207–212CrossRef Ishibashi Y, Tsuda E, Sasaki T, Toh S (2005) Magnetic resonance imaging AIDS in detecting concomitant injuries in patients with tibial spine fractures. Clin Orthop Relat Res 434:207–212CrossRef
18.
Zurück zum Zitat Jang KM, Bae JH, Kim JG, Wang JH (2013) Novel arthroscopic fixation method for anterior cruciate ligament tibial avulsion fracture with accompanying detachment of the anterior horn of the lateral meniscus: three-point suture fixation. Injury 44(8):1028–1032CrossRefPubMed Jang KM, Bae JH, Kim JG, Wang JH (2013) Novel arthroscopic fixation method for anterior cruciate ligament tibial avulsion fracture with accompanying detachment of the anterior horn of the lateral meniscus: three-point suture fixation. Injury 44(8):1028–1032CrossRefPubMed
19.
Zurück zum Zitat Johnson AC, Wyatt JD, Treme G, Veitch AJ (2014) Incidence of associated knee injury in pediatric tibial eminence fractures. J Knee Surg 27(3):215–219PubMed Johnson AC, Wyatt JD, Treme G, Veitch AJ (2014) Incidence of associated knee injury in pediatric tibial eminence fractures. J Knee Surg 27(3):215–219PubMed
20.
Zurück zum Zitat Kocher MS, DiCanzio J, Zurakowski D, Micheli LJ (2001) Diagnostic performance of clinical examination and selective magnetic resonance imaging in the evaluation of intraarticular knee disorders in children and adolescents. Am J Sports Med 29(3):292–296PubMed Kocher MS, DiCanzio J, Zurakowski D, Micheli LJ (2001) Diagnostic performance of clinical examination and selective magnetic resonance imaging in the evaluation of intraarticular knee disorders in children and adolescents. Am J Sports Med 29(3):292–296PubMed
21.
Zurück zum Zitat Kocher MS, Micheli LJ, Gerbino P, Hresko MT (2003) Tibial eminence fractures in children: prevalence of meniscal entrapment. Am J Sports Med 31(3):404–407PubMed Kocher MS, Micheli LJ, Gerbino P, Hresko MT (2003) Tibial eminence fractures in children: prevalence of meniscal entrapment. Am J Sports Med 31(3):404–407PubMed
22.
Zurück zum Zitat LaPrade CM, Ellman MB, Rasmussen MT, James EW, Wijdicks CA, Engebretsen L, LaPrade RF (2014) Anatomy of the anterior root attachments of the medial and lateral menisci: a quantitative analysis. Am J Sports Med 42(10):2386–2392CrossRefPubMed LaPrade CM, Ellman MB, Rasmussen MT, James EW, Wijdicks CA, Engebretsen L, LaPrade RF (2014) Anatomy of the anterior root attachments of the medial and lateral menisci: a quantitative analysis. Am J Sports Med 42(10):2386–2392CrossRefPubMed
23.
Zurück zum Zitat Lowe J, Chaimsky G, Freedman A, Zion I, Howard C (2002) The anatomy of tibial eminence fractures: arthroscopic observations following failed closed reduction. J Bone Joint Surg Am 84-A(11):1933–1938CrossRefPubMed Lowe J, Chaimsky G, Freedman A, Zion I, Howard C (2002) The anatomy of tibial eminence fractures: arthroscopic observations following failed closed reduction. J Bone Joint Surg Am 84-A(11):1933–1938CrossRefPubMed
24.
Zurück zum Zitat Magnussen RA, Mansour AA, Carey JL, Spindler KP (2009) Meniscus status at anterior cruciate ligament reconstruction associated with radiographic signs of osteoarthritis at 5- to 10-year follow-up: a systematic review. J Knee Surg 22(4):347–357CrossRefPubMedPubMedCentral Magnussen RA, Mansour AA, Carey JL, Spindler KP (2009) Meniscus status at anterior cruciate ligament reconstruction associated with radiographic signs of osteoarthritis at 5- to 10-year follow-up: a systematic review. J Knee Surg 22(4):347–357CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat McDermott MJ, Bathgate B, Gillingham BL, Hennrikus WL (1998) Correlation of MRI and arthroscopic diagnosis of knee pathology in children and adolescents. J Pediatr Orthop 18(5):675–678CrossRefPubMed McDermott MJ, Bathgate B, Gillingham BL, Hennrikus WL (1998) Correlation of MRI and arthroscopic diagnosis of knee pathology in children and adolescents. J Pediatr Orthop 18(5):675–678CrossRefPubMed
26.
Zurück zum Zitat McLennan JG (1982) The role of arthroscopic surgery in the treatment of fractures of the intercondylar eminence of the tibia. J Bone Joint Surg Br 64(4):477–480CrossRefPubMed McLennan JG (1982) The role of arthroscopic surgery in the treatment of fractures of the intercondylar eminence of the tibia. J Bone Joint Surg Br 64(4):477–480CrossRefPubMed
27.
Zurück zum Zitat Meyers MH, Mc KF (1959) Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am 41-A(2):209–220CrossRefPubMed Meyers MH, Mc KF (1959) Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am 41-A(2):209–220CrossRefPubMed
28.
Zurück zum Zitat Mitchell JJ, Sjostrom R, Mansour AA, Irion B, Hotchkiss M, Terhune EB, Carry P, Stewart JR, Vidal AF, Rhodes JT (2015) Incidence of meniscal injury and chondral pathology in anterior tibial spine fractures of children. J Pediatr Orthop 35(2):130–135CrossRefPubMed Mitchell JJ, Sjostrom R, Mansour AA, Irion B, Hotchkiss M, Terhune EB, Carry P, Stewart JR, Vidal AF, Rhodes JT (2015) Incidence of meniscal injury and chondral pathology in anterior tibial spine fractures of children. J Pediatr Orthop 35(2):130–135CrossRefPubMed
29.
Zurück zum Zitat Molander ML, Wallin G, Wikstad I (1981) Fracture of the intercondylar eminence of the tibia: a review of 35 patients. J Bone Joint Surg Br 63-B(1):89–91PubMed Molander ML, Wallin G, Wikstad I (1981) Fracture of the intercondylar eminence of the tibia: a review of 35 patients. J Bone Joint Surg Br 63-B(1):89–91PubMed
30.
Zurück zum Zitat Monto RR, Cameron-Donaldson ML, Close MA, Ho CP, Hawkins RJ (2006) Magnetic resonance imaging in the evaluation of tibial eminence fractures in adults. J Knee Surg 19(3):187–190PubMed Monto RR, Cameron-Donaldson ML, Close MA, Ho CP, Hawkins RJ (2006) Magnetic resonance imaging in the evaluation of tibial eminence fractures in adults. J Knee Surg 19(3):187–190PubMed
31.
Zurück zum Zitat Newman JT, Carry PM, Terhune EB, Spruiell MD, Heare A, Mayo M, Vidal AF (2015) Factors predictive of concomitant injuries among children and adolescents undergoing anterior cruciate ligament surgery. Am J Sports Med 43(2):282–288CrossRefPubMed Newman JT, Carry PM, Terhune EB, Spruiell MD, Heare A, Mayo M, Vidal AF (2015) Factors predictive of concomitant injuries among children and adolescents undergoing anterior cruciate ligament surgery. Am J Sports Med 43(2):282–288CrossRefPubMed
32.
Zurück zum Zitat Oiestad BE, Engebretsen L, Storheim K, Risberg MA (2009) Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 37(7):1434–1443CrossRefPubMed Oiestad BE, Engebretsen L, Storheim K, Risberg MA (2009) Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 37(7):1434–1443CrossRefPubMed
33.
Zurück zum Zitat Prince JS, Laor T, Bean JA (2005) MRI of anterior cruciate ligament injuries and associated findings in the pediatric knee: changes with skeletal maturation. AJR Am J Roentgenol 185(3):756–762CrossRefPubMed Prince JS, Laor T, Bean JA (2005) MRI of anterior cruciate ligament injuries and associated findings in the pediatric knee: changes with skeletal maturation. AJR Am J Roentgenol 185(3):756–762CrossRefPubMed
34.
Zurück zum Zitat Samora WP 3rd, Palmer R, Klingele KE (2011) Meniscal pathology associated with acute anterior cruciate ligament tears in patients with open physes. J Pediatr Orthop 31(3):272–276CrossRefPubMed Samora WP 3rd, Palmer R, Klingele KE (2011) Meniscal pathology associated with acute anterior cruciate ligament tears in patients with open physes. J Pediatr Orthop 31(3):272–276CrossRefPubMed
35.
Zurück zum Zitat Shea KG, Grimm NL, Laor T, Wall E (2011) Bone bruises and meniscal tears on MRI in skeletally immature children with tibial eminence fractures. J Pediatr Orthop 31(2):150–152CrossRefPubMed Shea KG, Grimm NL, Laor T, Wall E (2011) Bone bruises and meniscal tears on MRI in skeletally immature children with tibial eminence fractures. J Pediatr Orthop 31(2):150–152CrossRefPubMed
36.
Zurück zum Zitat Shin YW, Uppstrom TJ, Haskel JD, Green DW (2015) The tibial eminence fracture in skeletally immature patients. Curr Opin Pediatr 27(1):50–57CrossRefPubMed Shin YW, Uppstrom TJ, Haskel JD, Green DW (2015) The tibial eminence fracture in skeletally immature patients. Curr Opin Pediatr 27(1):50–57CrossRefPubMed
37.
Zurück zum Zitat Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 51(3):170–179CrossRefPubMedPubMedCentral Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 51(3):170–179CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Wilfinger C, Castellani C, Raith J, Pilhatsch A, Hollwarth ME, Weinberg AM (2009) Nonoperative treatment of tibial spine fractures in children-38 patients with a minimum follow-up of 1 year. J Orthop Trauma 23(7):519–524CrossRefPubMed Wilfinger C, Castellani C, Raith J, Pilhatsch A, Hollwarth ME, Weinberg AM (2009) Nonoperative treatment of tibial spine fractures in children-38 patients with a minimum follow-up of 1 year. J Orthop Trauma 23(7):519–524CrossRefPubMed
39.
Zurück zum Zitat Zaricznyj B (1977) Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. J Bone Joint Surg Am 59(8):1111–1114CrossRefPubMed Zaricznyj B (1977) Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. J Bone Joint Surg Am 59(8):1111–1114CrossRefPubMed
Metadaten
Titel
Meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures
verfasst von
Matthias J. Feucht
Peter U. Brucker
Carlo Camathias
Karl-Heinz Frosch
Michael T. Hirschmann
Stephan Lorenz
Hermann O. Mayr
Philipp Minzlaff
Wolf Petersen
Tim Saier
Dorien Schneidmüller
Amelie Stoehr
Daniel Wagner
Norbert P. Südkamp
Philipp Niemeyer
Publikationsdatum
27.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 2/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4184-0

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