Why paediatric knee surgery is not just knee surgery on small knees

Paediatric knee surgery is a developing subspecialty in the UK. The rise in early participation of children in organized competitive sports has led to an increase in knee injury presentations, and brings unique challenges. Children's knee surgery encompasses varied and complex pathologies, and combines expertise in soft tissue and arthroscopic techniques with an understanding of the unique characteristics of children, their skeleton and growth potential. Children are inherently high-risk surgical candidates due to ligamentous laxity, growth potential, difficulties in rehabilitating post-surgery and risks of re-injury. Goals of treatment include management of instability and pain, restoration of function and rehabilitation, in order to preserve the knee for the child's future. This review will focus on the commonly presenting problems of cruciate, meniscal and patellofemoral pathology.