Valgus Knee Injury

Case
This football player presented immediately following a valgus injury to his planted left leg.  He was struck in a heavy challenge and sustained a valgus force through his knee.  On the sideline he was found to have laxity of his medial collateral ligament both in extension and in 30 degrees of knee flexion.  Within 15 minutes of the injury he had also developed an effusion.

Findings
These MRI images have shown changes typicaly of a valgus injury.  The coronal PD FS image has shown a high grade tear of the player’s medial collateral ligament.  There is also a bone bruising pattern involving the posterior aspect of his lateral femoral condyle.

Discussion
Given that the medial collateral ligament was lax in both extension and in 30 degrees of knee flexion the player was managed in a hinged knee brace (unlocked) for an initial four week period.  During this time range of motion exercises were encouraged.  He was also advised to begin work on some quad activation exercises and to use a stationary bike.  During this time his pain improved substantially.  There was an improvement in the clinical laxity at the four week mark and he was allowed to start a progressive jogging programme.  He was able to return to football with his knee taped and braced at the 10 week mark.  There was some residual laxity with a valgus stress in 30 degrees knee flexion but his knee was stable in extension.  At the six month follow-up he was playing football without restriction and without the use of any aids.

Important notice
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Bangoura
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Une déchirure du LLI chez un sportif entraîne toujours des dégâts très importants
A mon avis ce traitement ressemble à celui d un footballeur de loisir qui n a aucune ambition vers l avenir
Pour un sportif professionnel de haut niveau ayant effectué l IRM une déchirure du ligament interne entraîne soit un décollement osseux ou une probabilité d une atteinte du MÉNISQUE INTERNE donc une chirurgie s impose pour un meilleur retour aux activités sportives