DePhillipo Nicholas N, Berning Kevin, LaPrade Robert F
The Steadman Clinic, Vail, CO, USA.
Twin Cities Orthopedics, Edina, MN, USA.
Int J Sports Phys Ther. 2020 Feb;15(1):139-147.
Multi-ligament knee injuries (MLKI) can be debilitating and often career ending injuries for athletes. Current literature reports on outcomes following these injuries for return to activities of daily life; however, there is a paucity of evidence evaluating the return to sport following a MLKI. The purpose of this case report is to describe the treatment and outcome following a MLKI and novel meniscus radial repair technique in which the athlete returned to compete in the 2018 Winter Olympic Games 14 months postoperatively.
Case Report.
A healthy 28-year-old female Olympic alpine skier who sustained a deep knee flexion with varus force injury to her right knee during a competitive skiing event. Examination and imaging revealed a completely torn anterior cruciate ligament (ACL) and lateral collateral ligament (LCL), complex radial tear of the lateral meniscus, medial meniscus tear, popliteofibular ligament tear, proximal tibiofibular joint ligament tear, and a common peroneal nerve neuropraxia. The athlete underwent an anatomic single-stage, multi-ligament knee reconstruction surgery which consisted of a novel meniscus radial repair technique.
A return to snow progression was initiated at seven months postoperatively. At 10 months postoperatively, a physical exam revealed trace effusion, no joint line tenderness, and negative stability tests. A repeat MRI revealed adequate healing of the lateral meniscus radial repair. The athlete passed a functional sports test at 10-months postoperatively and was cleared to return to ski with no restrictions. At 12 months postoperatively, the athlete placed in an Olympic qualifying ski race. At 14 months postoperatively, the athlete competed in the 2018 Olympic Winter Games.
This case report highlights the ability of an athlete to return to elite level of competition following an anatomic single-stage, multi-ligament knee reconstruction with a novel meniscus radial repair in a safe but timely manner.
多韧带膝关节损伤（MLKI）可能会使运动员丧失能力，且常常终结其运动生涯。当前文献报道了此类损伤后恢复日常生活活动的结果；然而，评估MLKI后恢复运动的证据却很匮乏。本病例报告的目的是描述一例MLKI的治疗及结果，以及一种新型半月板放射状修复技术，该运动员术后14个月重返赛场并参加了2018年冬奥会。
病例报告。
一名28岁健康的女子奥运高山滑雪运动员，在一次竞技滑雪赛事中右膝遭受屈膝内翻暴力损伤。检查及影像学显示前交叉韧带（ACL）和外侧副韧带（LCL）完全撕裂、外侧半月板复杂放射状撕裂、内侧半月板撕裂、腘腓韧带撕裂、胫腓近端关节韧带撕裂以及腓总神经失用症。该运动员接受了一期解剖性多韧带膝关节重建手术，其中包括一种新型半月板放射状修复技术。
术后7个月开始恢复雪地训练。术后10个月，体格检查显示有微量积液，无关节线压痛，稳定性试验为阴性。再次MRI显示外侧半月板放射状修复愈合良好。该运动员术后10个月通过了功能性运动测试，被批准无限制地恢复滑雪。术后12个月，该运动员参加了奥运会资格滑雪比赛。术后14个月，该运动员参加了2018年冬奥会。
本病例报告强调了一名运动员在接受一期解剖性多韧带膝关节重建并采用新型半月板放射状修复后，能够安全且及时地重返精英级别的比赛。
4级。
