Glossary
Growth plates around the knee
Quick answer
Growth plates are thin discs of cartilage near the ends of children's long bones where new bone is made. Around the knee there are major plates at the lower femur and upper tibia, and they usually close by the late teens, as Doha knee surgeon Dr. Pablo Gelber explains to parents at Aman Hospital.
What they are
The growth plates, or physes, at the lower femur and upper tibia produce a large share of the leg's growth in length. Smaller growth areas, called apophyses, sit at the tibial tubercle and the lower tip of the kneecap, where tendons pull. On X-ray, an open growth plate looks like a dark line across the bone. The plates usually close a little earlier in girls than in boys, generally between about 14 and 18 years.
Why they matter for patients
Growth plate cartilage is weaker than the surrounding bone, ligaments and tendons. In a child, an injury that would sprain a ligament in an adult can instead fracture through a growth plate. These fractures need careful assessment because damage to the plate can occasionally lead to uneven growth or a difference in leg length.
Repeated pulling on the smaller growth areas causes common, usually self-limiting conditions in active children, such as Osgood–Schlatter disease below the kneecap. When a teenager tears the ACL, the surgeon takes the open growth plates into account and uses techniques designed to protect them, with follow-up until growth is complete.
How they are examined
X-rays show whether plates are open and reveal fractures, sometimes compared with the other knee. MRI shows subtle plate injuries and helps plan treatment.
Frequently asked questions
Can a child have ACL surgery with open growth plates?
Yes, in many cases. Surgeons use techniques that avoid or limit crossing the growth plates and monitor growth afterwards. The timing is decided case by case.
When should I worry about knee pain in my child?
Seek prompt assessment if the child cannot bear weight, the knee is swollen or deformed after injury, there is fever, night pain or limping without a clear cause.
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