The majority of research on medial (MCL
) and lateral (LCL
) collateral ligament
injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament
injuries in adolescents, and assess timing for return to sports.
Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging–confirmed isolated MCL
injury over an 8-year period. Retrospective review then documented patient and injury characteristics and clinical course. General linear modeling was used to analyze risk factors for prolonged return to sports, continued pain or reinjury.
Fifty-one knees (33 in males, 65%), mean age 13.8 years (range, 5 to 17), were identified, of which 40 (78%) had MCL
injuries. Over half (29, 57%) of knees had an open distal femoral physis including all 5 bony avulsion injuries. Eleven (22%) had LCL
injuries of which 3 (6%) had concurrent posterolateral corner injuries. Forty-two (82%) knees had injuries that occurred during sports. Eleven knees (28%) with MCL
tears had a simultaneous patellar instability episode. Knee injuries
that occurred during sports had 37% shorter recovery time (P
=0.02). Eight knees (16%) experienced a reinjury and 12 (24%) were followed over an extended period of time for various knee issues. Football injuries were more likely to be grade 3 (P
=0.03), and football and soccer accounted for all grade III injuries. The mean return to sports was 2.2 months, with grade III cases returning at 2.4 months, and 95% of cases within 4 months.
Isolated collateral ligament
injuries are rare in adolescent athletes. MCL
injuries, one-quarter of which occurred in conjunction with patellar instability events, were 4 times more common than LCL
injuries, one quarter of which have other posterolateral corner structures involved. Grade III injuries represent 20% to 25% of collateral ligament
injuries and occurred most commonly in football and soccer.
Level of Evidence:
Level IV—retrospective case series.