Injuries of the anterior cruciate ligament, an algorithm helps the youngest

by time news

An algorithm helps specialists identify the best treatment for ruptures anterior cruciate ligament in younger patients. In the last twenty years, the incidence of these injuries has increased significantly in children and teenagers due to an increase in sports. Although cases recur more and more frequently, there is no univocal therapeutic path. The identification of the optimal treatment among the many possible options is closely related to the circumstances of the patient and the type of injury. The algorithm developed does not exclude clinical experience, but enhances it since it is based on it.


Researchers fromUniversity of Milan-Bicocca, dell’San Gerardo Hospital of Monza, of the Grenoble Alpes University and the Transalpine Center of Pediatric Sports Medicine and Surgery – in collaboration with their colleagues from Toulouse (France), Rochester (USA) and Thunder Bay (Canada) – carried out a review of all the scientific literature on the subject and of the case studies of the respective centers . A work that led to the development of a treatment selection algorithm based on three conditions: skeletal development; the location, type and quality of the lesion; the patient’s and parents’ expectations regarding future activities. The results of the study merged into an article published in “The Journal of Sports Medicine and Physical Fitness”.

The algorithm developed by the researchers and the advances in the treatment of anterior cruciate ligament ruptures in very young patients will be the topic of the third congress of Transalpine Center of Pediatric Sports Medicine and Surgery, scheduled for next December 3 at the congress center of the San Gerardo Hospital in Monza. In the four sessions in which the day is divided, the specialists will also address issues related to prevention and rehabilitation programs. The Transalpine Center of Pediatric Sports Medicine and Surgery was born from the collaboration between the University of Milan-Bicocca and the Grenoble Alpes University with the aim of creating a synergy for taking charge of young athletes, thus compensating for the lack of a highly specialized reference center.

In tears of the anterior cruciate ligament, the decision on the best therapeutic treatment for the specific case can sometimes be made only during surgery. Just for this a moment the relationship that specialists establish with the patient’s parents is important, so that the latter are enabled to give informed consent for the type of intervention that will be chosen.

“In the skeletally immature subjects, which have a high regenerative potential, for some crusader injuries a reparative treatment and not reconstructive, “he explains Marco Turati, researcher of the Department of Medicine and Surgery of the University of Milan-Bicocca, medical director of the Orthopedics department of the San Gerardo Hospital in Monza and president of the congress of the Transalpine Center of Pediatric Sports Medicine and Surgery. Then he adds: «This type of treatment allows the preservation of native ligament tissue. In other cases, instead, reconstruction of the cruciate is recommended since it has been shown that postponing treatment until the subject presents characteristics of skeletal maturity exposes him to a high risk of associated injuries. Finally, the algorithm that we have presented highlights how the optimal treatment does not only involve specific surgical choices on the individual patient, but also adapted rehabilitation paths that allow functional recovery as adequate as possible “.

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