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Current Trends and Challenges in the Diagnosis and Management of Pediatric Knee Disorders

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Dr. Marcin K. Krzysztof Waśko

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Department of Radiology and Imaging, The Medical Center of Postgraduate Education, Warsaw, Poland
Interests: pediatric knee disorders; skeletal immaturity and knee pathologies; growth plate injuries; congenital and developmental knee conditions; pediatric sports knee injuries

Special Issue Information

Dear Colleagues,

Pediatric knee disorders represent a complex and evolving field in pediatric orthopedics, with a broad spectrum of conditions ranging from congenital anomalies and developmental disorders to traumatic injuries and overuse syndromes. Accurate diagnosis and timely management are essential to prevent long-term functional impairments and promote optimal musculoskeletal development.

This Special Issue aims to bring together original research, clinical studies, and comprehensive reviews that explore recent advances in imaging, surgical and non-surgical treatments, rehabilitation strategies, and long-term outcomes in pediatric knee pathologies. We especially welcome contributions addressing diagnostic challenges, innovations in minimally invasive techniques, sports-related injuries in growing athletes, and interdisciplinary approaches to care.

We invite authors to share their latest findings and clinical experiences to foster a deeper understanding of current challenges and emerging solutions in this vital area. By compiling diverse perspectives and up-to-date evidence, this Special Issue seeks to support improved care pathways and guide future research in pediatric knee health.

Dr. Marcin K. Krzysztof Waśko
Guest Editor

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15 pages, 6464 KB

Open AccessArticle

Association of Elevated Body Mass Index with Tibial Tuberosity Avulsion Fractures in Pediatric Athletes: A Pilot Retrospective Study

by Josip Kocur, Slavko Čičak, Damjan Dimnjaković, Izabela Kiš, Gordana Kristek, Krešimir Ivković, Dalibor Kristek and Dalibor Divković

Medicina 2025, 61(9), 1698; https://doi.org/10.3390/medicina61091698 - 18 Sep 2025

Viewed by 263

Abstract

Background and Objectives: Tibial tuberosity avulsion fractures are rare injuries in pediatric athletes, with limited data on the potential role of an elevated body mass index (BMI) as a risk factor. Previous studies have primarily focused on age, sex, and sport type, but the association between BMI and these injuries remains underexplored. Tibial tuberosity avulsion fractures are rare injuries predominantly affecting adolescent boys during sports activities involving strong quadriceps contractions. This pilot study aimed to analyze the epidemiological and anthropometric characteristics of patients with these fractures, including the distribution of injury mechanisms and the fracture types, to test whether the prevalence of overweight/obesity among cases exceeded national population benchmarks, and to describe the associated clinical outcomes. Materials and Methods: A retrospective analysis was conducted on medical records and radiographs of patients under the age of 18 treated between 2017 and 2024. The data collected included demographic and anthropometric characteristics, injury mechanisms, fracture classification, treatment methods, complications, and outcomes. The patients were categorized as normal weight (<85th percentile) or overweight/obese (≥85th percentile). The primary outcome was whether the prevalence of overweight/obesity among the cases exceeded national pediatric benchmarks. Formal sample size and power analyses were performed to guide future research. Results: Twenty-one patients met the inclusion criteria, with a mean age of 13.7 years; 95.2% were male. Soccer was the most common injury mechanism (52.4%), followed by athletics and running. The predominant fracture type was Ogden IVb (38.1%). Overweight/obesity was present in 52.4% of the patients, significantly higher than the national benchmarks. An open reduction and internal fixation was performed in 90.5% of the cases, with a mean follow-up of 14.6 months (range: 6–36). Complications occurred in 14.3% overall, all within the overweight/obese group (27.3%). Conclusions: This pilot retrospective study suggests a potential link between an elevated BMI and tibial tuberosity avulsion fractures, with overweight/obesity being significantly more prevalent in affected patients than in the general pediatric population. These exploratory findings warrant confirmation in larger, adequately powered studies, and emphasize the importance of weight management and tailored sports activities as potential preventive strategies. An early diagnosis, timely surgical intervention, and adequate rehabilitation are critical for achieving optimal functional recovery. Full article

(This article belongs to the Special Issue Current Trends and Challenges in the Diagnosis and Management of Pediatric Knee Disorders)

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