Knee trauma in children

Specialty: Children's Orthopaedic
Age group: Children

Criteria for referral to public hospital service

• Assessment following re-examination after initial treatment (compression, ice, analgesia, period of non-weight bearing and physiotherapy)
  • anterior or posterior cruciate ligament (ACL) rupture
  • medial or lateral collateral ligament injury
  • meniscal injury
• Recurrent patellar dislocation.

Information to be included in the referral

Information that must be provided

• Reason for referral and expectation or outcome, anticipated by the child, or their carer, and the referring clinician from referral to the health service
• Findings on physical examination, where relevant include results of clinical ligament and meniscus tests completed
• Date, mechanism, severity, recurrence and evolution of injury
• Details of previous management including the course of treatment(s) and outcome of treatment(s)
• Pain history: onset, location, nature of pain and duration
• Child’s age
• X-ray of two views of the affected knee: weight bearing anteroposterior (AP), lateral and skyline views (including details of the diagnostic imaging practice).

Provide if available

• Results from most recent IKDC subjective knee evaluation form, or similar function rating questionnaire
• MRI scan where there is ligament damage (including details of the diagnostic imaging practice)
• Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
• If the child is neurodiverse, gender diverse or has a disability
• If the child identifies as an Aboriginal and/or Torres Strait Islander
• If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
• If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
• If younger than 18 years if they may have been harmed, or at risk of harm
• If the child is aged 14 to 18 years, do they consent that their health information is shared with their parent, guardian or carer.

Additional comments

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Ultrasound imaging is not indicated.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• First episode of patellar dislocation able to be reduced.