Return to Play After Medial Collateral Ligament Injury

Kim, Christopher; Chasse, Patrick; Taylor, Dean C.

doi:10.1016/j.csm.2016.05.011

Cited by 33 publications

(34 citation statements)

References 33 publications

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“…Wikstrom et al reported that a consensus was reached on the need to evaluate sports-specific movement in the decision of RTS after LAS; however, this statement was obtained by reviewing only low-level retrospective studies [ 20 ]. The lack of evidence regarding the criteria for RTS after conservative treatment has also been reported, not only in the LAS but also in knee ligament injuries [ 40 , 41 ]. However, given the fact that almost half of LASs occur in athletes [ 1 , 2 ], and that athletes with LAS are at a high-risk of recurrence [ 6 , 39 ], high-quality studies are mandatory to construct definitive criteria for RTS after LAS.…”

Section: Discussionmentioning

confidence: 99%

The current clinical practice of general orthopaedic surgeons in the treatment of lateral ankle sprain: a questionnaire survey in Miyazaki, Japan

Yokoe

Tajima

Yamaguchi

et al. 2021

BMC Musculoskelet Disord

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Background Lateral ankle sprain (LAS) is one of the most common musculoskeletal injuries. Numerous studies regarding LAS have been performed. However, there are few studies evaluating the current clinical practice of orthopaedic surgeons regarding LAS. The purpose of this study was to evaluate the current clinical practice of general orthopaedic surgeons in the treatment of LAS. Methods A questionnaire survey was conducted from September 2020 to December 2020 in Miyazaki, Japan, to evaluate the clinical practice of general orthopaedic surgeons in the treatment of LAS. The survey was composed of 12 questions that were developed with consideration of the recommendations in the current clinical practice guidelines (CPGs) published by the Dutch orthopaedic society. The questions in this study were focused on the diagnosis, conservative treatment, rehabilitation, and the criteria for return to sports (RTS). Results The survey response rate was 82.7% (129/156). Among the respondents, 95.3% did not consider the Ottawa Ankle Rules in the decision to perform plain radiography for patients. Rehabilitation following LAS was performed in 58.9% of patients. Eighty-five (65.9%) of the surgeons used only one factor as the criterion for RTS. The absence of pain was the most frequently used criterion (45.7%). No objective criteria were used for the RTS decision in athletes with LAS. Conclusions The present study suggested that most general orthopaedic surgeons do not provide the care for patients with LAS recommended by the current CPGs. No objective criteria for the RTS decision are used for athletes with LAS.

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Section: Discussionmentioning

confidence: 99%

The current clinical practice of general orthopaedic surgeons in the treatment of lateral ankle sprain: a questionnaire survey in Miyazaki, Japan

Yokoe

Tajima

Yamaguchi

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…It was not possible to determine the specific degree of injury severity, along with individual differences in treatment and rehabilitation, because of the absence of access to official medical record documentation and radiographic imaging or reports. However, several prior studies have correlated MCL injury grade with length of time lost, 17,23,34 with player absence having been established as a reliable proxy variable within the ongoing UEFA injury study. 8…”

Section: Discussionmentioning

confidence: 99%

Return-to-Play Times and Player Performance After Medial Collateral Ligament Injury in Elite-Level European Soccer Players

Lavoie-Gagne

Retzky

Diaz

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Participation in elite-level soccer predisposes athletes to injuries of the medial collateral ligament (MCL), resulting in variable durations of time lost from sport. Purpose: To (1) determine the rate of return to play (RTP) and timing after MCL injuries, (2) investigate MCL reinjury incidence after RTP, and (3) evaluate the long-term effects of MCL injury on future performance. Study Design: Descriptive epidemiology study. Methods: Using publicly available records, we identified athletes who had sustained MCL injury between 2000 and 2016 across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A). Injured athletes were matched to controls using demographic characteristics and performance metrics from the season before injury. We recorded injury severity, RTP rate, reinjury incidence, player characteristics associated with RTP within 2 seasons of injury, player availability, field time, and performance metrics during the 4 seasons after injury. Results: A total of 59 athletes sustained 61 MCL injuries, with 86% (51/59) of injuries classified as moderate to severe and surgical intervention performed in 14% (8/59) of athletes. After injury, athletes missed a median of 33 days (range, 3-259 days) and 4 games (range, 1-30 games). Overall, 71% (42/59) of athletes returned successfully at the same level, with multivariable regression demonstrating no athlete characteristic predictive of RTP. MCL reinjury was reported in 3% (2/59) of athletes. Midfielders demonstrated decreased field time after RTP when compared with controls ( P < .05). No significant differences in player performance for any position were identified out to 4 seasons after injury. Injured athletes had a significantly higher rate of long-term retention ( P < .001). Conclusion: MCL injuries resulted in a median loss of 33 days in elite European soccer athletes, with the majority of injuries treated nonoperatively. RTP remained high, and few athletes experienced reinjury. While midfielders demonstrated a significant decrease in field time after RTP, player performance and long-term retention were not compromised. Future studies are warranted to better understand athlete-specific and external variables predictive of MCL injury and reinjury, while evaluating treatment and rehabilitation protocols to minimize time lost and to optimize athlete safety and health.

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“…It is also important to not excessively stress the joint such that knee effusions develop due to activities that overuse quadriceps and cause lower extremity weakness. 34 , 35 …”

Section: Rehabilitationmentioning

confidence: 99%

Posterior oblique ligament of the knee: state of the art

et al. 2021

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The posterior oblique ligament (POL) is the predominant ligamentous structure on the posterior medial corner of the knee joint. A thorough understanding of the anatomy, biomechanics, diagnosis, treatment and rehabilitation of POL injuries will aid orthopaedic surgeons in the management of these injuries. The resulting rotational instability, in addition to valgus laxity, may not be tolerated by athletes participating in pivoting sports. The most common mechanism of injury – accounting for 72% of cases – is related to sports activity, particularly football, basketball and skiing. Moreover, three different injury patterns have been reported: those associated with injury to the capsular arm of the semimembranosus (SM), those involving a complete peripheral meniscal detachment and those involving disruption of the SM and peripheral meniscal detachment. The hallmark of an injury related to POL lesions is the presence of anteromedial rotatory instability (AMRI), which is defined as ‘external rotation with anterior subluxation of the medial tibial plateau relative to the distal femur’. In acute settings, POL lesions can be easily identified using coronal and axial magnetic resonance imaging (MRI) where the medial collateral ligament (MCL) and POL appear as separate structures. However, MRI is not sensitive in chronic cases. Surgical treatment of the medial side leads to satisfactory clinical results in a multi-ligamentous reconstruction scenario, but it is known to be associated with secondary stiffness. In young patients with high functional demands, return to sports is allowed no earlier than 9–12 months after they have undergone a thorough rehabilitation programme. Cite this article: EFORT Open Rev 2021;6:364-371. DOI: 10.1302/2058-5241.6.200127

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Return to Play After Medial Collateral Ligament Injury

Cited by 33 publications

References 33 publications

The current clinical practice of general orthopaedic surgeons in the treatment of lateral ankle sprain: a questionnaire survey in Miyazaki, Japan

The current clinical practice of general orthopaedic surgeons in the treatment of lateral ankle sprain: a questionnaire survey in Miyazaki, Japan

Return-to-Play Times and Player Performance After Medial Collateral Ligament Injury in Elite-Level European Soccer Players

Posterior oblique ligament of the knee: state of the art

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