Cruciate ligament injury in children represents a special problem, as the child is still growing and the growth plates have to be avoided if possible when considering surgical stabilisation.
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One option often employed by the surgeon is to do nothing - avoiding damaging the growth plates, but leaving the knee unstable and the child unable to participate in sports and risking secondary damage to the menisci and joint cartilage.
Alternatively attempts can be made to improve joint stability with a stabilising procedure outside of the actual joint cavity, which used to be the traditional approach to cruciate tears in the adult in the days before the 1970s.
Some surgeons will risk the growth plate disturbance and perform a standard modern adult cruciate reconstruction procedure, damaging as little of the growth plate as possible.
This eBook explores a different approach - repairing the damage rather than replacing the existing ligament material, but reinforcing the repair until healing has occurred. Interference with the growth plates may be totally avoided or minimised with very small tunnels through the bone.