For young athletes with a sports-related injury, we know it’s important that they not only get back in the game but receive treatment that supports the ongoing health of their still-growing bones.
We provide our patients with comprehensive treatment that includes age-appropriate and injury-specific rehabilitation plans, coordinating with rehabilitation and other specialists throughout Johns Hopkins All Children’s as needed.
Surgical treatment for sports injuries at Johns Hopkins All Children’s is provided by the surgeons at Children’s Orthopaedic and Scoliosis Surgery Associates, L.L.P. (COSSA). Paul Benfanti, M.D., and Drew Warnick, M.D., are board-certified orthopaedic surgeons and sports medicine specialists.
Some injuries that most often require surgical care include:
Femoroacetabular impingement (FAI)
FAI is a disorder in which the bones of the hip are abnormally shaped and rub against each other, damaging the joint. Chronic groin pain in adolescents or young adults who play sports is an early sign of FAI—left untreated, it can cause osteoarthritis. While tests such as radiographs and special MRI reconstruction techniques can help diagnose FAI, signs are often subtle, and it is best diagnosed by a pediatric orthopaedic surgeon who is familiar with the condition. Hip arthroscopy or surgical dislocation of the hip repairs damage and reshapes the injured area to help relieve pain, restore range of motion and prevent arthritis.
Labral tears of the hip
A labral tear is a tear of the labrum, which is the elastic tissue around the hip joint, or the cartilage in the hip. A labral tear may happen alongside other conditions, including FAI or hip dysplasia. Labral tears can happen as a result of repetitive motions in sports, such as running or throwing. Surgical treatment to repair the torn labrum or cartilage includes hip arthroscopy or surgical dislocation of the hip.
Anterior Cruciate Ligament (ACL) tears
We most often see injuries of the ACL—one of the four main ligaments in the knee—in children and young adults who play sports that involve sudden, sharp changes of direction, like football, soccer and basketball. Surgical ACL reconstruction stabilizes the knee joint to allow your child to return to their sport and prevent further damage to the meniscus or cartilage while their bones continue to grow.
The meniscus is a C-shaped cartilage in the knee joint that helps protect the bearing surface of the knee. We are now seeing meniscus tears more often in children and young adults participating in sports, when a sudden twisting of the knee, pivoting or deceleration causes a tear in the cartilage. Meniscus tears that don’t heal on their own and cause continued pain, locking or instability of the knee may need surgery.
Patellar subluxation and dislocation
This is a condition of the knee in which the patella, or kneecap, becomes unstable and dislocated, causing pain, swelling and difficulty walking. In young athletes, it may be caused by a direct blow to the knee that causes the patella to sharply slide out of place. Left untreated, this can cause permanent damage to the knee. Surgery may be needed to repair and tighten the ligaments around the kneecap.
Bony and soft tissue ankle impingement
Ankle impingement occurs when the bones of the ankle are abnormally shaped, causing the bones to hit against each other during movement. This causes pain in the front of the ankle, especially when the foot is flexed upward. Arthroscopic surgery may be needed to reshape the bone, which helps reduce pain and other symptoms and prevent further damage.
Osteochondral lesions of talus
This is an injury of the talus—the bottom bone of the ankle joint—that may involve both the bone and cartilage around the ankle, causing pain, swelling and ankle instability. The injury may be caused by an ankle sprain, and involve lesions on the bone, blistering of the cartilage layers, or fractures of the bone and cartilage layer. Surgery may be needed to restore the shape of the talus and the gliding surface of the joint.
A sudden impact to the shoulder can cause the top of the upper arm bone to dislocate from the socket of the shoulder blade. This is most common in young athletes who play contact sports. A dislocated shoulder is prone to repeated dislocation, which can cause damage to nerves, blood vessels, tendons or ligaments, and may require surgery to prevent further instability and restore range of motion.
Multidirectional shoulder instability
When the ligaments that hold the shoulder bone together don’t function as tightly as they should, this can cause multidirectional shoulder instability, causing the shoulder to feel loose and the patient to experience extra movement in their shoulder. This can happen in young athletes who engage in activities that involve a lot of shoulder movement, like throwing or swimming. For more severe instability, surgery may be needed to fix the issue and relieve symptoms like pain, swelling and arm weakness.
Osteochondritis dissecans of the elbow
When a young athlete overuses his or her elbow, this can cause a piece of bone or cartilage in the elbow to loosen. The piece of bone or cartilage can eventually separate from the joint, causing pain, limited motion and degeneration of the elbow joint. Older children and young adults often need surgery to remove the loose bone fragments from the elbow.
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We are ready to answer your questions. For more information or to schedule an appointment, call the Children's Orthopaedic and Scoliosis Surgery Associates (COSSA) office.
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Additional conditions we treat include:
- Loose bodies
- Cartilage injuries
- Legg-Calve-Perthes disease
- Slipped capital femoral epiphysis
- Pelvic avulsion fractures
- Posterior cruciate ligament tears
- Collateral ligament tears
- Discoid meniscus
- Femur fractures
- Tibia fractures
Foot and Ankle
- Ankle sprains
- Ankle and foot fractures
- Ankle instability
- Accessory navicular
- Symptomatic ossicles
- Tarsal coalition
- Labral tears
- Acromioclavicular joint injuries
- Clavicle fractures
- Humerus fractures
- Panner disease
- Elbow and forearm fractures
- Ulnar collateral ligament injuries
Visit COSSA's website
Children's Orthopaedic and Scoliosis Surgery Associates provide surgery and services at Johns Hopkins All Children's Hospital.