Biochemical and cytokine environment in skeletally immature patients after traumatic knee injuries

Traumatic knee injuries in skeletally immature patients occur in a unique biological context shaped by growth, high tissue turnover, and distinct immune-repair dynamics. Beyond structural damage, acute post-traumatic changes in synovial fluid and cartilage metabolism can set the trajectory toward persistent symptoms and post-traumatic osteoarthritis. In this review, we synthesize recent evidence on the biochemical and cytokine milieu following common pediatric and adolescent knee injuries, including Anterior Cruciate Ligament tears, meniscal lesions, and osteochondral trauma. We highlight patterns of early inflammatory signaling, matrix-degradation biomarkers, and emerging pro-resolving mediators, and discuss how age, timing of sampling, and injury phenotype influence reported profiles. We then outline the translational relevance of these biomarkers for patient stratification, prognosis, and therapeutic targeting, including opportunities to define windows for disease-modifying interventions. Finally, we propose priorities for the field: standardized sampling and reporting, and longitudinal pediatric cohorts linked to imaging and outcomes.