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The Knee: Ligamentous Tears

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Pediatric and Adolescent Sports Traumatology

Abstract

In children and adolescents, the knee is exposed to bone, osteochondral, ligamentous, and capsular injuries secondary to direct or indirect trauma. In the last 20 years, the observation of knee ligament injuries in children has increased. This may due to a wider, more intense, and earlier participation in competitive sports and/or an improvement in diagnostic accuracy achieved with MRI and arthroscopy. Clinical and instrumental diagnosis has been refined to individualize various degrees of medial and lateral collateral ligament (LCL) tears, helping to select patients requiring surgical therapy. The treatment for avulsion ligament injuries of the anterior and posterior cruciate ligaments (PCL) was improved by the evolution of surgical arthroscopy. Moreover, particular attention was directed toward recognizing and treating complete anterior cruciate ligament (ACL) tears. Traditional conservative treatment for these ACL injuries in adolescents leads to anterior knee laxity and chronic instability, unlike in active mature patients. In recent years, attention has been placed on surgical treatment for ACL tears using various intra-articular techniques to reconstruct the ACL with tendon grafts fixed in both anatomic areas of insertion of the native ligament, but adapted for growing lower limbs. The goal is to provide an ACL reconstruction able to obtain good results from a biomechanical point of view without the risk of growth disturbances.

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Author information

Authors and Affiliations

  1. Department of Orthopedics, Pediatric Hospital Bambino Gesù, S. Onofrio square 4, 00165, Rome, Italy

    Francesco Falciglia & Antonio Di Lazzaro

  2. Department of Orthopedics, Pediatric Hospital Bambino Gesù, University of Cassino and Southern Lazio, S. Onofrio square 4, 00165, Rome, Italy

    Vincenzo Guzzanti

Authors
  1. Francesco Falciglia
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  2. Antonio Di Lazzaro
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  3. Vincenzo Guzzanti
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Correspondence to Vincenzo Guzzanti .

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Editors and Affiliations

  1. Bambino Gesù Children's Hospital Rome, University of Cassino, Rome, Italy

    Vincenzo Guzzanti

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Falciglia, F., Di Lazzaro, A., Guzzanti, V. (2014). The Knee: Ligamentous Tears. In: Guzzanti, V. (eds) Pediatric and Adolescent Sports Traumatology. Springer, Milano. https://doi.org/10.1007/978-88-470-5412-7_12

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  • DOI: https://doi.org/10.1007/978-88-470-5412-7_12

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