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Isolated Lateral Collateral Ligament Injuries do not need surgery

Description

Objective

To illustrate the success of non-operative treatment of isolated LCL injuries in elite athletes as reflected by successful return to play (RTP) and performance level.

Methods

A consecutive series of elite athletes with injuries to the posterolateral corner (PLC) of the knee treated by two sports knee surgeons between 2015 and 2021 were identified.

Only those with isolated LCL injuries were included.

RTP was defined as competing in at least one event at professional level or national/ international level in amateur sport. Demographic, clinical examination findings, radiological findings, RTP and subsequent career longevity were analysed.

Results

Forty-two athletes (36 football players) with a mean age of 24.1 years (± 3.9 years) were included. All patients were treated with restricted activities and rehabilitation.  Forty-two athletes (36 football players) with a mean age of 24.1 years (± 3.9 years) were included. All patients were treated with restricted activities and rehabilitation.

RTP was 100% at a mean of 108 days (± 99 days).

At 2 years, 40 patients (95.2%) were still playing elite sport. 90.3% (28 out of 31 players) were still playing elite sport at 5 years (Figure 1). Fourteen athletes (33.3%) had already ended their career at the timepoint of this study. Their mean career longevity after the injury was 66.1 months (± 26.9 months).

MRI grading did not correlate with clinical grading (r(36)=0.086, p=0.618) (Figure 2).

No athlete stopped elite sport due to the LCL injury.  

Conclusions

Truly isolated LCL injury in an athlete does not need surgery. It most commonly affects football players. The present study showed 100% of cases RTP at a mean of 15 weeks. A secondary finding is that MRI grading of LCL injury does not correlate with clinical laxity nor predict outcome.

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Author

M K

Matthew KJ Jaggard

Homerton University Hospital NHS Trust

D J

David J. Haslhofer

Fortius Clinic London

M J

Mary Jones

Fortius Clinic London

A M

Adam Mitchell

Fortius Clinic London

J L

Justin Lee

Fortius Clinic London

S V

Simon V Ball

Fortius Clinic London

A W

Andy Williams

Fortius Clinic London

ESSKA Continuous Professional Education Partners