Stener-like Injuries

The Princess Grace Hospital in London has published a new study into stener-like injuries in the American Journal of Sports Medicine. One of the rarest sports injuries, it is known to significantly impede healing.

Here, we will look at what the latest study found, and what a stener-like injury of the MCL is.

What is MCL?

The MCL (medial collateral ligament), is a stabilising ligament in the knee. It is one of four ligaments that starts at the end of the thigh bone (femur) and ends at the top of the shin (tibia). Its main function is to prevent the knee from opening, and like all ligaments it is at risk of being injured or torn.

When a tear occurs, it tends to affect the top of the MCL where it attaches to the femur. However, it is possible for patients to experience a tear at the bottom near the shin. If a tear does develop in the bottom, it will usually take longer to heal than a tear at the top of the MCL.

What causes an MCL injury?

MCL injuries can be caused by a range of factors including bending or twisting when playing sports. It can also occur due to a knock to the outside of the knee. Injuries are graded depending upon their severity, ranging from Grade 1-3. Normally, an ACL injury causes worse pain than an MCL injury – with more widespread swelling around the knee and sometimes an audible ‘pop’ sound.

Stener-like injuries of the MCL are rare, but they are frequently linked to ACL tears and require surgery as early as possible. They occur when superficial MCL fibres tear, while the deeper fibres stay intact. The superior fibres can become displaced, preventing the MCL from healing.

What did the latest study find?

The latest study followed 23 elite athletes aged 19-37, who underwent surgery by the same surgeon. Most participants were men, including 16 football players, and 7 rugby players. The minimum follow up was 24 months after the surgery date.

A total of 15 athletes underwent an anatomic suture anchor repair isolated to the distal tibial insertion site. Eight of the athletes needed an anatomic suture anchor repair at both the distal and proximal attachment sites.

All participants managed to get back to pre-injury sporting levels, with the mean time to return being 16.8 + 2.7 weeks.

The surgical approach to treat stener-like lesions of the MCL resulted in a high return rate to pre-injury sporting levels. Additionally, it showed a low risk of recurrence.

One thing that can’t be overlooked is the importance of rehab after surgical repair. Physiotherapy plays a crucial role in helping athletes to get back to their pre-injury fitness levels. Those who have been diagnosed with stener-like MCL injuries should also seek treatment as soon as possible. This will prevent the injury from worsening, increasing the chance of a faster recovery.

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