Long-term outcomes and epidemiology of specific pediatric knee injuries

This doctoral dissertation at the University of Oulu found that the treatment of pediatric knee injuries generally yields good long-term outcomes, but there are important differences between surgical techniques. In particular, medial patellofemoral ligament (MPFL) reconstruction was associated with a lower risk of osteoarthritis and fewer reoperations compared with traditional Insall proximal realignment.

The knee is one of the most commonly injured joints in children and adolescents, accounting for approximately 40% of all sports-related injuries. Management of pediatric knee injuries is challenging due to open growth plates and ongoing skeletal development, requiring careful consideration of treatment methods to avoid growth disturbances and to ensure normal knee function.

The dissertation addressed three main topics. First, it compared two treatment methods for tibial spine avulsion fractures: open reduction with osteosuturing and arthroscopic screw fixation. Both methods produced good long-term outcomes, but patients treated with open reduction and osteosuturing returned more often and more quickly to their preinjury sport level.

Second, the study evaluated surgical treatment outcomes for patellar instability in skeletally immature patients. MPFL reconstruction proved superior to Insall proximal realignment, reducing the development of osteoarthritis and the need for reoperations, and more often enabling return to preinjury sports level.
Third, the study examined the incidence and risk factors of proximal tibial fractures related to trampoline injuries. The results showed that the annual incidence of these fractures doubled over the 12-year study period.