ACL tear and medial and lateral meniscal tears
Prior to the MRI results, we recommended relative rest with modalities and medication for pain control.
After the MRI, the patient underwent left knee arthroscopy and ACL reconstruction with a hamstring autograft. No meniscal tears were seen on direct visualization.
After the surgical procedure, the patient began a complete ACL program, which began as a rehabilitation program prior to surgery.
The patient did well post-op with decreased pain and swelling and increased motion and function. Physical therapy continued, resulting in increased strength and agility.
The patient was later lost to follow-up.
The most likely nonfatal injury in soccer is a contusion. Boys aged 16 - 18 had higher rates of injury in a study evaluating age and injury rates. In a study evaluating rates of injury with player-to-player contact, almost half of soccer injuries occurred during tackling. Up to 1/4 of acute soccer injuries occur in the knee.
ACL injuries have been associated with running sports and sports that involve pivoting. The mechanism of injury typically results from a valgus knee position, coupled with pronation of the foot and extension of the knee and hip. As such, the mechanism of injury in our patient was likely related improper slide tackle by an opposing soccer player
The ACL is the most commonly injured knee ligament and 70% occur in high risk sports like soccer, football, basketball, volleyball, skiing and gymnastics.
Many patients like our this 16 year old feel a pop during the injury, followed by instability during squatting, pivoting, or stepping laterally or bearing the entire weight on the injured foot when walking down the stairs.
1) AAP Council on Sports Medicine and Fitness. Injuries in Youth Soccer: A Subject Review. Pediatrics 105(3);2000:659-661.
2) Weiss Kelly AK. Anterior Cruciate Ligament Injury Prevention. Curr. Sports. Med. Rep. 7(5);2008:255-262.
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