Non-operative treatment for partial ruptures of the fibular collateral ligament occurring in combination with complete ruptures of the anterolateral ligament: a common injury pattern in Brazilian Jiu-jitsu athletes presenting with acute knee injury

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Temponi, EF, Saithna, A ORCID: https://orcid.org/0000-0002-2408-5307, Carvalho, LH, Teixeira, BP and Sonnery-Cottet, B, 2019. Non-operative treatment for partial ruptures of the fibular collateral ligament occurring in combination with complete ruptures of the anterolateral ligament: a common injury pattern in Brazilian Jiu-jitsu athletes presenting with acute knee injury. Orthopaedic Journal of Sports Medicine, 7 (1). ISSN 2325-9671

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Official URL: https://doi.org/10.1177/2325967118822450

Abstract

Background: Combined partial lateral collateral and complete anterolateral ligament (PLCCALL) injuries are a specific injury pattern seen in Brazilian Jiu-jitsu due to the knee varus/flexion mechanism that frequently occurs during grappling.

Purpose: The aim of this article was to evaluate the incidence of this injury pattern in a series of Brazilian Jiu-jitsu athletes with an acute knee injury, and also to evaluate clinical and functional outcomes after non-operative management, at a minimum follow up of one year.

Hypothesis: Our hypotheses were that partial lateral collateral and complete anterolateral ligament (PLCCALL) injuries are common in BJJ and that non-operative treatment is associated with excellent clinical outcomes and return to the pre-injury level of sport

Study Design: Case series – cohort

Methods: All Brazilian Jiu-jitsu athletes presenting with an acute knee injury between July 2013 and June 2017 who underwent MRI of the knee were included. A specific emphasis was placed on identifying those whose imaging demonstrated PLCCALL injury. Clinical evaluation included physical examination, Lysholm and International Knee Documentation Committee (IKDC) score.

Results: Of the 27 patients analyzed, seven (25.9%) were identified to have MRI proven PLCCALL injuries. The mean follow-up was 41.3 months. The mean IKDC/Lysholm score pre-injury was 94.3/92, at initial assessment after injury was 26/35.6 and this improved to 82.8/78.2 at 12 months post-injury (p<0.00001). All seven patients returned to the pre-injury level of sports after one year of follow-up. The mean time between injury and return to competition level was 4.7 months (range 4-6).

Conclusion: Combined partial LCL rupture and complete rupture of the ALL is a specific but infrequent injury pattern in BJJ. The prognosis of this injury following non-operative treatment appears to be excellent. Improved functional scores (IKDC and Lysholm) and MRI demonstrate that the ALL has intrinsic healing potential because the images show complete healing of the previously documented rupture of the anterolateral ligament from its proximal attachment.

Clinical Relevance: The present article primarily evaluates the incidence of a specific injury pattern in a large series of Brazilian Jiu-Jitsu athletes with an acute knee injury, and also evaluates clinical and functional outcomes of these patients. The second major finding of this study is that these injuries can heal as proven by improved functional scores (IKDC e Lysholm) and subsequent MRI, how has been debate in the recent literature.

Item Type:	Journal article
Description:	Article no. 2325967118822450
Publication Title:	Orthopaedic Journal of Sports Medicine
Creators:	Temponi, E.F., Saithna, A., Carvalho, L.H., Teixeira, B.P. and Sonnery-Cottet, B.
Publisher:	Sage
Date:	2019
Volume:	7
Number:	1
ISSN:	2325-9671
Identifiers:	Number Type 10.1177/2325967118822450 DOI
Rights:	This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Divisions:	Schools > School of Science and Technology
Record created by:	Linda Sullivan
Date Added:	07 Nov 2018 15:54
Last Modified:	29 May 2019 14:48
URI:	https://irep.ntu.ac.uk/id/eprint/34868