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. 2021 Jun 1;56(6):565-571.
doi: 10.4085/1062-6050-465-19.

Distal Medial Collateral Ligament Grade III Injuries in Collegiate Football Players: Operative Management, Rehabilitation, and Return to Play

Josue Acevedo  1 , Allison L Boden  1 , Dylan N Greif  1 , Christopher P Emerson  1 , Jeffrey T Ruiz  1 , Jean Jose  2 , Luis A Feigenbaum  1 , Lee D Kaplan  1
Affiliations

Distal Medial Collateral Ligament Grade III Injuries in Collegiate Football Players: Operative Management, Rehabilitation, and Return to Play

Josue Acevedo et al. J Athl Train. .

Abstract

Context: Management of isolated grade III medial collateral ligament injuries is controversial, as both nonoperative and operative management can result in return to play. However, operative management is recommended in elite athletes who have a grade III injury with distal avulsion.

Objective: We present a standardized rehabilitation protocol in a case series of 7 National Collegiate Athletic Association Division I American football athletes who sustained grade III distal medial collateral ligament tears that were repaired operatively, with emphasis on return to play.

Results: Median time to surgery was 4 days (range = 2-67 days). Median time from surgery to noncontact drills was 120.5 days (range = 104-168 days), and median time from surgery to full-contact sport was 181 days (range = 139-204 days). All athletes returned to play at their preinjury level of competition.

Conclusions: Our study highlighted how operative management with a standardized rehabilitation protocol can be applied to Division I football players and result in safe return to play.

Keywords: case series; knee; physical rehabilitation.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging. A, Coronal proton density fat saturation and B, coronal proton density T1 images demonstrate avulsion of the medial collateral ligament from its tibial insertion with proximal retraction of the ligament (arrows).
Figure 2
Figure 2
A, Open dissection of the superficial structures to reveal the superficial medial collateral ligament (arrows). B, Surgical repair of the grade III medial collateral ligament avulsion injury using a double-row suture technique (arrows).
See this image and copyright information in PMC

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