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Management of Collateral Ligament Injuries (Medial and Lateral) in Competitive Athletes

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Arthroscopy and Sport Injuries

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Abstract

Medial collateral ligament (MCL) is the principal passive restraint to valgus forces applied to the knee and, along with other anatomic structures such as hamstrings muscles, is responsible for the stability of the medial compartment of the knee on the coronal plane. In a sportsmen population, MCL is frequently ruptured alone or in association with menisci and cruciate ligaments. The wide area of the lesion’s surface and the relatively high blood supply of the MCL explain the very high rate of spontaneous healing without need of surgical reparation or reconstruction. Return to play will be possible only at the resolution of pain and after having achieved a sufficient stability at the clinical exam. Surgical reparation in athletes can find an indication in the presence of a bony avulsion, in multiligamentous injuries, and in the presence of an isolated complete tear involving both midsubstance and tibial insertion. In the case of a clinically relevant chronic medial instability, the surgical indication is mandatory. Although isolated lateral collateral ligament (LCL) lesions are extremely rare, a varus instability-associated component is frequently noticed in the presence of a posterolateral instability or in multiligamentous injuries. Grade I and II lesions of the LCL and PLC are generally treated conservatively with full extension long-leg knee brace. In grade III injury of LCL and PLC, the risk of developing a chronic instability is very high, and the treatment of these lesions is mainly surgical.

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Authors and Affiliations

  1. SSD Chirurgia Articolare del Ginocchio, Istituto Ortopedico Gaetano Pini Milano, Piazza A. Cardinal Ferrari 1, Milan, 20122, Italy

    Massimo Berruto, Paolo Ferrua, Francesco Mattia Uboldi, Eva Usellini & Stefano Pasqualotto

  2. Dipartimento Ortotraumatologia Generale e Chirurgie Ortopediche Specialistiche, Istituto Ortopedico Gaetano Pini, Piazza A.Cardinal Ferrari 1, Milan, 20122, Italy

    Marelli Bruno Michele

Authors
  1. Massimo Berruto
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  2. Paolo Ferrua
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  3. Francesco Mattia Uboldi
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  4. Eva Usellini
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  5. Stefano Pasqualotto
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  6. Marelli Bruno Michele
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Correspondence to Massimo Berruto .

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Editors and Affiliations

  1. Knee Orthopedics and Sport Traumatology Unit,, Humanitas Clinical Institute IRCCS, Milan, Italy

    Piero Volpi

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Berruto, M., Ferrua, P., Uboldi, F.M., Usellini, E., Pasqualotto, S., Michele, M.B. (2016). Management of Collateral Ligament Injuries (Medial and Lateral) in Competitive Athletes. In: Volpi, P. (eds) Arthroscopy and Sport Injuries. Springer, Cham. https://doi.org/10.1007/978-3-319-14815-1_40

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  • DOI: https://doi.org/10.1007/978-3-319-14815-1_40

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14814-4

  • Online ISBN: 978-3-319-14815-1

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