Sport Injuries

Dr. George Jacob

MBBS, MS Ortho, FAOA

Sports injuries of the knee are a common occurrence, whether it be in recreational or competitive levels of sports.

The most common of these injuries are Anterior Cruciate Ligament (ACL) injuries. Other ligaments injured in the knee include the Posterior Cruciate Ligament (PCL), Medial Collateral Ligament, and Lateral Collateral Ligament.

For example, ACL injuries occur, usually in a sudden stop or change in direction, while PCL injuries occur as a result of a knee joint hyperextension. Most sporting injury mechanisms result in injuries to more than just one of these ligaments and each injury mechanism has its well-described pattern of injury. These are termed multi-ligament injuries and are quite severe injuries that need careful evaluation and timely intervention. Another possible injury is patella dislocation, and some individuals have a higher chance of this depending on their anatomy or ligament laxity. The treatment for these injuries varies depending on the severity of the injury and the activity requirement of the patient.

The gold standard treatment for ACL injuries is a reconstruction using an autograft, however, some favourable injury patterns allow for repair techniques to be employed. Occasionally with additional risk factors, reconstruction is combined with lateral augmentation methods and realignment osteotomies. Patella dislocations often include a medial patella femoral ligament reconstruction and sometimes an additional bony procedure to improve bony anatomy.

Other commonly encountered injuries are Cartilage injuries and Meniscal tears. Both structures are within the knee joint and therefore have a poor blood supply and healing potential. The meniscus is an important structure in the knee joint that effectively acts as a shock absorber to the knee joint and convert and reduces vertically applied forces into a smaller circumferential force known as the “hoop stress mechanism”. Meniscal tears occur in different locations and different patterns, each having varying prognoses of healing and indication of surgery.

Articular cartilage covers the entire joint surface of the knee to provide a low-friction, smooth surface for the bones to glide against each other efficiently.
The poor blood supply of cartilage and the meniscus make healing a challenge and often they must be treated surgically to restore their function and integrity. This is again a decision based on the injury profile and activity level of the patient. Often there are biological augmentation methods that may be suggested to enhance the healing potential of an injury that otherwise has poorer outcomes.

“ Almost all the surgeries offered for these injuries are performed arthroscopically and Dr. Jacob prefers to discuss the injury profile with his patients and then suggest the most appropriate indicated surgical option. ”

With all sporting injuries physiotherapy and rehabilitation are important often before and after the surgery. In some cases, injuries may be managed non-operatively with a rehabilitation protocol. Nonetheless, Dr. Jacob considers rehabilitation and physiotherapy imperative for an efficient and comprehensive recovery. To achieve this, he works alongside qualified sports physiotherapists and exercise physiologists to design efficient rehab strategies for everyone. 

Ligament Injury 

  • Arthroscopic Ligament Reconstructions and Repair
  • MPFL Reconstruction

Meniscus Treatments 

  • Arthroscopic Meniscus Repair/ Meniscectomy 

Cartilage Treatments 

  • Autologous Chondrocyte Implantation (ACI)
  • Particulate Autologous Chondral-Platelet-Rich Plasma Matrix Implantation 
  • Osteochondral Autograft Transfer/ Mosaicplasty 
  • Microfracture 
  • Chondroplasty

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