Pediatric Sports Medicine Program

We specialize in the treatment of pediatric sports injuries. This expertise is particularly valuable, as unique aspects of the pediatric anatomy are imperative to growth and development. Understanding these and other pediatric distinctions is essential to realizing the best possible outcomes and preventing future injuries.

The range of sports-related injuries varies, and can include sprains, strains, growth plate injuries, injuries of the anterior cruciate ligament (ACL), osteochondritis dissecans, patella subluxation/dislocation, discoid meniscus and shoulder dislocations.

If recognized early, many of these conditions can be successfully treated without surgery. At times, however, surgery offers better potential outcomes. In these instances, surgery can often be performed in a minimally invasive manner, resulting in less pain and faster recovery.

The anterior cruciate ligament in the knee joint provides knee stability, particularly during physical activity. It is important for both contact and noncontact sports. Following an injury, most athletes maintain the ability to walk and bend at the knee, most athletes require surgery to regain the knee stability needed for return to their pre-injury level of competition.

Anterior cruciate ligament (ACL) reconstruction is a surgery designed to rebuild a new ligament that can take the place of the damaged or torn ACL. This reconstructed ligament is usually borrowed from the patient’s own tissue and involves using the patellar tendon with some adjacent bone or one of the hamstring tendons. The selected tissue is then passed through a tunnel created within the tibia, across the knee joint and into another tunnel created in the femur. It is secured on either end using an implant, often a screw. Because children and young adults have open growth plates that need to be protected, this surgical technique is modified to ensure that the growth plate is preserved and subsequent growth can proceed normally.

Surgery is generally an outpatient procedure, and patients can return home the same day. Patients are required to protect the knee following surgery, allowing time for the reconstructed tissues to heal. This generally requires the temporary use of crutches. Physical therapy is commonly prescribed. Specific recommendations and instructions are offered based on patient-specific conditions and needs.

Osteochondritis dissecans is a condition that occurs when the supporting layer of bone below the articular cartilage becomes ischemic due to poor blood flow. The affected bone and cartilage can loosen or dislodge entirely, leading to pain and other mechanical symptoms. This condition most commonly affects the cartilage within the knee, but it can also be encountered in many other joints. Nonoperative treatment is often effective, particularly in young patients. In some instances, surgery offers better results.

When surgery is needed, osteochondritis dissecans is generally managed in a minimally invasive manner using arthroscopic techniques. Surgery is performed by making a small incision through which a specialized miniature camera is inserted. Additional small incisions allow for other arthroscopic instruments to be introduced as well. The unhealthy bone is drilled or prepared to stimulate new, healthy blood flow to the region. Finally, the detached bone or cartilage fragment is reattached to its original anatomic location.

Surgery is generally an outpatient procedure, and patients can return home the same day. Patients are required to protect the joint following surgery, allowing time for the bone and soft tissues to heal. For the lower extremities, this generally requires the temporary use of crutches. Physical therapy is commonly prescribed. Specific recommendations and instructions are offered based on patient-specific conditions and needs.

Patellar dislocation occurs when the patella (kneecap) shifts entirely out of its normal position. Patellar subluxation occurs when the patella continues to shift out of place partially, an event that commonly follows a frank dislocation. Sometimes this occurs due to loose ligaments or bony anatomy, both of which make the kneecap less stable. Aside from causing pain, continued dislocation or subluxation can result in abnormal forces across the knee and may lead to early arthritis. Although conservative methods can sometimes address these conditions, ongoing instability is often best managed with surgery.

Medial patellofemoral instability surgery is designed to recreate one of the stabilizing ligaments that tethers the patella and is responsible for its proper tracking/movement as the knee bends and extends. This reconstructed ligament (graft) may be harvested from the patient or procured from a tissue bank. The selected tissue is then attached to anatomically accurate positions, tethering the patella to the femur and preventing it from slipping out of place during knee movement. In some cases, the procedure is combined with a lateral release, which frees up some of the tight tissue on the opposing side of the kneecap.

Surgery is generally an outpatient procedure, and patients can return home the same day. Patients are required to protect the knee following surgery, allowing time for the bone and soft tissues to heal. This may require the temporary use of a knee brace and/or crutches. Physical therapy is commonly prescribed after a period of rest. Specific recommendations and instructions are offered based on patient-specific conditions and needs.

The meniscus is a specialized cartilaginous structure within the knee. It is located between the leg bone and thigh bone, serving as a shock absorber. It is normally C-shaped or O-shaped and runs along the periphery of each compartment within the knee. A discoid meniscus is a condition in which the meniscus is misshapen and therefore prone to causing mechanical locking or catching in the knee. It can also cause pain if it tears. In such cases, surgery is sometimes needed to minimize pain, restore function and prevent further tearing of the meniscus.

Discoid meniscus surgery is generally managed in a minimally invasive manner using arthroscopic techniques. Surgery is performed by making a small incision through which a specialized miniature camera is inserted into the knee joint. Additional small incisions allow for other arthroscopic instruments to be introduced, as well. The meniscus is then trimmed back to a more normal shape and contour. In some instances, the meniscus is also repaired or reattached to its normal anatomic position using very small sutures to secure it in place.

Surgery is generally an outpatient procedure, and patients can return home the same day. Patients are required to protect the knee following surgery, allowing time for the soft tissues to heal. This usually requires the temporary use of crutches. Physical therapy is commonly prescribed. Specific recommendations and instructions are offered based on patient-specific conditions and needs.

Shoulder instability most commonly occurs following a shoulder dislocation resulting from a trauma or an accident. When the shoulder dislocates, it often tears the labrum as well. The labrum is a rim of specialized tissue that surrounds the socket of the shoulder, serving as a bumper to provide added stability to the joint. Once a child or adolescent sustains a shoulder dislocation, the risk of recurrent instability is extremely high. Surgery is frequently required to repair the labrum and restore stability to the joint.

Shoulder instability surgery is generally managed in a minimally invasive manner using arthroscopic techniques. Surgery is performed by making a small incision through which a specialized miniature camera is inserted into the shoulder joint. Additional small incisions allow for other arthroscopic instruments to be introduced, as well. The labrum is then repaired or reattached to its normal anatomic position using anchors or very small sutures to secure it in place.

Surgery is generally an outpatient procedure, and patients can return home the same day. Patients are required to protect the shoulder following surgery, allowing time for the soft tissues to heal. This generally requires the temporary use of a sling or a brace. Physical therapy is commonly prescribed to help regain strength and motion. Specific recommendations and instructions are offered based on patient-specific conditions and needs.