Working Diagnosis:
Third Degree LCL Injury

Treatment:
The athlete was prescribed a stabilizing knee brace and permitted to bear weight as tolerated for the first 2 weeks. Over the next 4 weeks, he was progressed to activity as tolerated with the exclusion of cutting, twisting, pivoting, and impact movements.

Outcome:
Between 6 and 7 weeks after diagnosis, he was able to fully participate in athletics without pain or limitation.

Author's Comments:
Lateral collateral ligament injuries only account for 1-8% of all acute ligamentous injuries of the knee. The large majority of these are associated with other ligamentous or meniscal injuries. This case is an exception as it involves an isolated complete LCL tear. The limited recent studies available exploring treatment options for this injury pattern seem to support non-operative management, revealing a quicker return to play with similar functional outcomes when compared to operative management. What makes this case even more unusual is the minimal degree of symptoms in this athlete, allowing him to participate in nearly a full game of football after the initial impact. With this degree of functional stability and lack of associated injury, he was a great candidate for conservative treatment.

References:
1. Bushnell BD, Bitting SS, Crain JM, Boublik M, Schlegel TF. Treatment of Magnetic Resonance Imaging-Documented Isolated Grade III Lateral Collateral Ligament Injuries in National Football League Athletes. Am J Sports Med. 2010;38(1):86-91.
2. Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: A 10-year study. Knee. 2006;13(3):184-8.
3. Swenson DM, Collins CL, Best TM, Flanigan DC, Fields SK, Comstock RD. Epidemiology of Knee Injuries among U.S. High School Athletes, 2005/2006-2010/2011. Med Sci Sports Exerc. 2013;45(3):462-9.

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