Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Mar 15;12(3):e227735.
doi: 10.1136/bcr-2018-227735.

ACL rupture in the immediate build-up to the Olympic Games: return to elite alpine ski competition 5 months after injury and ACL repair

Cesar Praz  1 , Vikram Kishor Kandhari  1 , Adnan Saithna  2   3 , Bertrand Sonnery-Cottet  1
Affiliations
Case Reports

ACL rupture in the immediate build-up to the Olympic Games: return to elite alpine ski competition 5 months after injury and ACL repair

Cesar Praz et al. BMJ Case Rep. .

Abstract

Anterior cruciate ligament (ACL) rupture in the immediate build-up to a major international competition can preclude an athletes' participation due to the prolonged period of rehabilitation that is typically required after ACL reconstruction. ACL repair is an alternative strategy that has been postulated to confer the advantage of rapid rehabilitation and earlier return to sport. A 33-year-old professional alpine skier sustained a right knee ACL rupture in September 2017. The athlete indicated that she wanted to participate in the 2018 Olympics. Arthroscopic ACL repair and reconstruction of the anterolateral ligament was undertaken. At 3 months, Lachman's test revealed a hard end point, a negative pivot shift and no side-to-side laxity difference. MRI at 6 and 12 weeks demonstrated a continuous ACL with no intraligament signal change. At 20 weeks postoperatively, she successfully participated in the slalom at the 2018 Olympic Games.

Keywords: knee injuries; ligament rupture; orthopaedic and trauma surgery.

PubMed Disclaimer

Conflict of interest statement

Competing interests: BS-C is a consultant for Arthrex and receives royalties from Arthrex. AS is a consultant for Arthrex.

Figures

Figure 1
Figure 1
MRI images of the right knee: (A) preoperative sagittal fat sat proton density MRI; (B) Day 1 postoperative sagittal fat sat proton density MRI demonstrating repaired anterior cruciate ligament (ACL); (C) Day 1 postoperative coronal fat sat proton density MRI demonstrating anterolateral ligament graft (white arrows); and (D) 3 months postoperative MRI. Isometric 3D Space Proton Density demonstrating normal appearances of ACL.
Figure 2
Figure 2
Intraoperative images of the right knee. (A) A suture passer is routed through the tibial tunnel. This allows a suture shuttle to be placed and the graft to be subsequently routed through the tibial tunnel. (B) One limb of the semitendinosus allograft is secured with the suture anchor (SwiveLock; Arthrex) in a femoral socket located proximal and posterior to the lateral epicondyle. (C) The free limb of the allograft is then routed under the iliotibial band toward the posterior tibial stab incision, passed through the tibial tunnel and shuttled back to the femoral stab incision.
Figure 3
Figure 3
Intraoperative arthroscopic images of the right knee. (A) A 4 mm tibial tunnel is drilled over a guidewire placed in the centre of the anterior cruciate ligament (ACL) stump and a FibreStick is passed through the entire ACL remnant. (B) Two stitches are placed in the ACL remnant with the knee Scorpion device. (C) Intra-articular view of the final appearance of the ACL repair. (D) Arthroscopic view of the lateral gutter with the two limbs of the FiberLink and TigerLink tensioned and knotted over the Tightrope button. (E) Illustration of the ACL repair and anterolateral ligament reconstruction with allograft.
See this image and copyright information in PMC

References

    1. Higgins RW, Steadman JR. Anterior cruciate ligament repairs in world class skiers. Am J Sports Med 1987;15:439–47. 10.1177/036354658701500503 - DOI - PubMed
    1. Ferretti A, Monaco E, Fabbri M, et al. Prevalence and classification of injuries of anterolateral complex in acute anterior cruciate ligament tears. Arthroscopy 2017;33:147–54. 10.1016/j.arthro.2016.05.010 - DOI - PubMed
    1. Inderhaug E, Stephen JM, Williams A, et al. Anterolateral tenodesis or anterolateral ligament complex reconstruction: effect of flexion angle at graft fixation when combined with ACL reconstruction. Am J Sports Med 2017;45:3089–97. 10.1177/0363546517724422 - DOI - PubMed
    1. Sonnery-Cottet B, Saithna A, Cavalier M, et al. Anterolateral ligament reconstruction is associated with significantly reduced acl graft rupture rates at a minimum follow-up of 2 years: a prospective comparative study of 502 patients from the SANTI Study Group. Am J Sports Med 2017;45:1547–57. 10.1177/0363546516686057 - DOI - PubMed
    1. Engebretsen L, Lew WD, Lewis JL, et al. The effect of an iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med 1990;18:169–76. 10.1177/036354659001800210 - DOI - PubMed

Publication types

MeSH terms