Medial Collateral Ligament Sprain Research Articles

Role of MRI in Evaluation of Post-Traumatic Knee Injuries: A Prospective Study

INTRODUCTIONThe knee joint is the largest and most complex joint in the human body. Therefore it is often affected by trauma. Magnetic Resonance Imaging (MRI) is a non-invasive imaging modality that provides detailed images of the soft tissue structures of the knee joint. The objective of this study was to evaluate MRI findings in patients with post-traumatic knee joint injuries. MATERIAL AND METHODSThis prospective study was carried out using a 3.0 Tesla MRI (Magnetom Lumina) scanner in the Department of Radiodiagno- sis and Medical Imaging at Universal College of Medical Sciences & Teaching Hospital, Bhairahawa, Nepal, involving 128 patients with knee injuries, from September 2023 to February 2024. Data were analyzed using SPSS version 20. RESULTSIn this study of 128 participants, 57.81% were male and 42.19% were female, with a mean age of 38.60±13.05 years. The majority of MRI findings were medial meniscus tear (51.56%), followed by anterior cruciate ligament tear (46.09%), medial collateral ligament sprain (44.53%), lateral meniscus tear (39.84%), lateral collateral ligament sprain (33.59%), and posterior cruciate ligament tear (17.97%). Our study also revealed various grades of collateral ligament injuries, including the medial and lateral ligaments. There were 59.65% of cases with a grade I medial collateral ligament sprain, followed by grade II at 33.33% and grade III at 7.02%. The grade I and grade II lateral collateral ligament sprains were 62.79% and 37.21%, respectively. CONCLUSIONMRI is a non-invasive and valuable diagnostic modality that can provide an accurate diagnosis. It is often preferred over arthroscopy.

Common sports injuries and physical treatments

Physiotherapy is a non-invasive and non-pharmaceutical application of artificial physical factors and natural physical factors to the human body through the body's neurological, humoral, endocrine, immune and other physiological regulatory mechanisms to achieve the purpose of treatment and rehabilitation. With the widespread popularity and popularity of sports, more people are participating in sports in which injuries become common at different levels of sports from daily recreation to high intensity competitive levels. Physical therapy is considered the first choice for sports people to treat sports injuries and is becoming common and mainstream in the field of sports injury treatment and rehabilitation. Physiotherapy has become critical as a primary treatment or secondary intervention after a sports injury and make sense in the rehabilitation of sports injuries. This article focuses on the physiotherapy treatment of common sports injuries in different sports. Common sports injuries in basketball include ankle sprains, meniscus tears, Achilles tendon ruptures, and patellar tendonitis. Common sports injuries in rugby include groin injuries and shoulder dislocations. Common sports injuries in baseball include ulnar collateral ligament injuries and rotator cuff injuries. Common sports injuries in tennis include epicondylitis of the elbow joint. Common injuries in soccer include medial collateral ligament sprains and calf strains. This article analyzes the anatomical structure of the above-mentioned common injury sites, the physical means of intervention and the different roles of physiotherapy in different sports injuries. The results of the article found that physiotherapy is available for all the sports mentioned above. However, depending on the injury in a sport, physiotherapy has a different proportion of the conventional treatment modalities.

Conservative Approach to Treating American Football Players With Medial Collateral Ligament Grade 2 Sprain During the Season.

The medial collateral ligament is the most commonly injured ligament in the knee. The high-speed pivoting and agility movements that are common in the sport of American Football put participants at an increased risk for a valgus force stress from contact or noncontact injuries. Positional release therapy (PRT) also considered strain/counterstrain focuses on releasing the tension in a tissue through unloading the involved body part. Two male student-athletes participating in football with a mean age of 20.5years were diagnosed by a physician with medial collateral ligament grade 2 sprain. Both patients sustained their injuries in a regular season game with a contact valgus force from an opposing player. After the initial 72hours of compression, elevation, and cryotherapy, the patients were both treated with PRT followed by progressive loading exercises. Following 4 treatment sessions of PRT over the next 6days, the patients started with quadriceps engagement exercises, single-leg squats to 60° knee flexion, side steps, triceps dips, slow controlled lunges, and toe walk. The patients progressed to full body weight squats, single-leg landing, step-up tri-extension, and sidekicks with a leg on table. Then, the patients completed function movements and sports-specific exercises. In this case series, 2 patients competing in intercollege American Football were treated with PRT and progressive loading exercises to facilitate return to unrestricted activities and improve outcome measures. Commonly, a grade 2 medial collateral ligament sprain is conservatively treated with return to sport taking 20days on average. In this type 2 case series, the clinician found success utilizing PRT early in the recovery process, which in these 2 cases lead to restoration of function, outcome measure improvement, and an expedited return to sport. The expedited return to sport occurred at an average of 18days for these patients.

Poster 359: Anorexia Nervosa and Bulimia Nervosa Diagnoses Are Associated with Increased Risk of Lower Extremity Soft Tissue Injury and Orthopaedic Surgery Requirements

Objectives: An abundance of literature exists demonstrating the link between eating disorders and fracture risk. However, no studies to our knowledge have investigated the impact of an eating disorder diagnosis on risk for ligamentous injury or the need subsequent orthopedic surgery. The aim of this study was therefore to elucidate this link and determine if pre-existing eating disorder diagnoses are associated with increased incidence of lower extremity connective tissue-related orthopaedic injuries and surgeries. We hypothesized that eating disorders, specifically anorexia nervosa and bulimia nervosa, lead to an increased risk of ligamentous injuries and need for surgery on injured ligaments. Methods: Patients with a diagnosis of anorexia nervosa or bulimia nervosa were identified using International Classification of Diseases (ICD) -9 and -10 codes using the PearlDiver Mariner insurance claims data set. These patients were matched by age, gender, Charlson Comorbidity Index, record dates, and geographical region to respective control groups without anorexia nervosa or bulimia nervosa. Instances of ligamentous injuries were identified through ICD-9 and ICD-10 codes within the time period of 2010-2020 available within the Mariner dataset. Instances of ligamentous orthopaedic surgery procedures in these patients were identified through Current Procedural Terminology (CPT) codes. Rates of ligamentous injury and orthopaedic surgery among experimental and control cohorts were analyzed using chi-squared analysis. Results: The anorexia nervosa cohort and its matched control group contained a total of 2,475 patients each. Patients with a diagnosis of anorexia nervosa were significantly more likely to sustain a meniscus tear (RR=1.57, p=0.001) or deltoid ligament sprain (RR=1.83, p=0.025), and to undergo anterior cruciate ligament (ACL) reconstruction (RR=2.83, p=0.037). They were less likely to sustain a tibiofibular ligament sprain (RR=0.64, p=0.012). The bulimia nervosa cohort and its matched control group contained a total of 2,375 patients each. Patients with a diagnosis of bulimia nervosa were significantly more likely to sustain a meniscus tear (RR=1.98, p <0.001), medial collateral ligament (MCL) sprain (RR=3.07, p<0.001), any cruciate ligament tear (RR=2.14, p=0.004), unspecified ankle sprain (RR=1.56, p<0.001), and any ankle ligament sprain (RR=1.27, p=0.008), and to undergo partial meniscectomy (RR=1.80, p=0.002). Conclusions: Diagnosis of an eating disorder is associated with an increased risk of certain ankle and knee ligamentous injuries and surgeries. Orthopaedic surgeons should be aware of the effects these disorders have on soft tissue injury and surgery rates. Furthermore, patients presenting to orthopaedic surgery clinics should be informed of increased risks associated with their eating disorder diagnoses and provided with information on resources promoting recovery to help prevent further injury.

Physiotherapy management on sprain medial collateral ligament in sports injury: a literature study

Background: The risk of sports activities is injuries. There are two types of injury classification often experienced by athletes: acute trauma and overuse. The part of the body in sports that are quite common injuries due to body contact is the knee. Medial collateral ligament (MCL) injuries were one of the most common knee injuries in sports. The role of physiotherapy in MCL injury conditions is to improve knee conditions in athletes, prevent re-current of injuries, help heal the athlete's condition after MCL injury with existing modalities and help restore the condition, which aims to make the athlete able to return to play in their sport.
 Methods: This study used library research which takes online and offline data sources to refer to books and scientific articles related to examination and physiotherapy intervention in the condition of MCL sprain injury.
 Results: Physiotherapists must carefully examine every symptom that appears by examining the basic function of motion, palpation, specific test with a valgus stress test, and functional evaluation in conditions of MCL sprain injury.
 Conclusions: In athletes, physiotherapy interventions must be graded, like reducing acute injury symptoms, exercising using tools, and reducing pain in the first phase; the second phase with increasing functional ability, flexibility, range of motion, and returning muscle strength; in the third phase, muscle strength must increase as before, returning agility, balance, and flexibility; furthermore, in the fourth phase, the athlete is prepared to return to sport with strength training, flexibility, agility, and sport-specific exercise.

Risk of Lower Extremity Ligamentous Injury Following Concussion Diagnosis: A TriNetX Database Study.

Background Concussion is one of the most frequently reportedsports-related injuries in the United States; there is evidence that residual deficits in neurocognition may increase the risk of lower extremity musculoskeletal injury after concussion in high school, college, and professional athletes. The purpose of this study is to identify whether similar trends are identified in community-based populations. Methods The TriNetX Research Network database was queried for patients 10-60 years old who experienced an ambulatory or emergency visit from 2018-2020. Cohorts were defined by patients seen for concussion and patients seen for other reasons. These cohorts were then propensity score matched based on significant differences in demographics; after matching, each cohort included 97,708 patients. The propensity score-matched cohorts were then evaluated to identify patients who experienced subsequent lower extremity ligamentous injury within 12 months. Results Patients with a history of concussion were more likely to experience posterior cruciate ligament (PCL) sprain (0.04% vs. 0.02%, risk ratio (RR)=1.79, p=.039), medial collateral ligament (MCL) sprain (0.18% vs. 0.08%, RR=2.355, p<.001), lateral collateral ligament (LCL) sprain (0.05% vs. 0.02%, RR=2.202, p=.003) and ankle sprain (1.05% vs. 0.47%, RR=2.265, p<.001). Conclusion Patients diagnosed with concussion were more likely to experience a lower extremity ligamentous injury when compared with patients who did not have concussion. Patients should be counseled regarding this increased risk and additional neuromuscular evaluation and injury prevention education may be indicated following concussion diagnosis.

Traumatic Hip Dislocation in an NCAA DI Football Player with Occult Sequelae: A Case Report.

Background and PurposeAmerican football generates the most sports-related injuries in the United States, with tackling as the leading injury mechanism. Overall injury rate at the collegiate level has been reported as 8.61 per 1,000 athlete exposures (AEs) – twice the rate of high school levels; competition injury rates are reported as high as 36.94/1000 AEs. Traumatic hip dislocation is an uncommon injury typically arising from high-energy axial impact with only 2-5.5% occurring during sports activities.Case DescriptionA 22-year-old NCAA Division I football defensive back who experienced extreme left hip pain following contact with another player with his hip flexed during a game was diagnosed with a type 1 posterior hip dislocation, a grade 1 medial collateral ligament sprain with concomitant posterior thigh and hip muscle strains. Key impairments were limited left lower extremity motor performance, range of motion deficits, left hip pain, and diminished function and weight-bearing ability.OutcomesThe athlete reintegrated into typical defensive back off-season training approximately four to five months post injury without restrictions, however presented with new anterior hip pain seven months post injury revealing occult sequelae requiring surgical intervention. He was able to return to full play the following football season.DiscussionThis case report describes the successful return to sport of a Division I football player who sustained a traumatic posterior hip dislocation and complicated course including surgical intervention secondary to associated sequelae.Level of Evidence5

Knee pain: Ultrasound and MRI correlation

Abstract Background Knee pain incidence is increasing among the community which has different multiple pathologies. Magnetic Resonance Imaging (MRI) is considered the gold standard imaging modality in diagnosing knee soft tissue injury. Ultrasound (US) is another modality which can be used in diagnosing soft tissue injury. Aim of the Work is to detect the reliability of US in diagnosing cases with knee pain as compared to MRI. Patients and Methods A prospective study was conducted on 20 patients with knee pain. They were referred from the Orthopedic and/or Rheumatology Department to Radiology department at Ain Shams University hospitals for MRI and US examination of the knee.The age group were from 19 to 59 years. Results In this study, 20 patients were examined with majority being males (75%). US was tested against MRI for different soft tissue pathologies.including knee effusion, meniscal pathology (tear, degeneration and extrusion), medial collateral ligament sprain, lateral collateral ligament sprain and Baker’s cyst. There was good agreement between US and MRI in most of these pathologies. US showed an overall sensitivity of 61.7% and specificity of 92.7% with accuracy of 86.9%. The overall PPV and NPV were 66.1% and 91.3% respectively. Conclusion Ultrasound can be considered a reliable screening imaging modality in cases of knee pain.

MRI-Detected Knee Ligament Sprains and Associated Internal Derangement in Athletes Competing at the Rio de Janeiro 2016 Summer Olympics.

PurposeDescribe the frequency and severity of knee ligament sprains diagnosed by MRI in athletes participating at the 2016 Summer Olympic Games, their association with certain sports and assess correlations with additional knee structural injury.Patients and MethodsAll knee MRIs performed in the Olympic Village and polyclinics during the 2016 Olympics were retrospectively, blindly reviewed for ligament sprains and associated knee injuries. In addition to the absence or presence of these abnormalities, athletes were stratified by age, gender and sport.Results11,274 athletes participated in the 2016 Olympic Games: 113 athletes received at least one knee MRI with some having bilateral or repeat MRI on the same knee. Anterior cruciate and medial collateral ligament (ACL/MCL) sprains were most common, accounting for 32 of the 43 sprains (74.4%). Wrestling (10), hockey (7), athletics (7), and judo (5) accounted for over half of ligament sprains. ACL sprains showed a significant positive correlation with medial, lateral meniscal tears and bone contusions. The positive correlation between posterior cruciate ligament (PCL) sprains with MCL/lateral collateral ligament sprain, and popliteus tendon tear was statistically significant with 50% of total PCL sprains occurring in hockey. When athletes were stratified by gender, ligament sprains had a similar occurrence and distribution between men and women.ConclusionKnee ligament sprains, at the Rio 2016 Games, were most common in wrestling, hockey, athletics and judo with ACL and MCL sprains most frequent. Meniscal tears and bone contusions occurred often with ACL sprains. PCL sprains tended to be multi-ligamentous injuries. Sustained ligament sprains had similar occurrence between genders, while men had a peak incidence of sprains at a younger age and women at an older age.

Chronic Medial Collateral Ligament Sprain Treated With Percutaneous Ultrasonic Debridement: A Case Report

The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. Most grade I and II injuries respond to conservative management, but symptoms persist in some patients. In these cases, treatment options are limited. Percutaneous ultrasonic debridement is increasingly being used for tendinopathy and fasciopathy refractory to conservative management, but this has not been reported as a treatment for ligament injury. Here, we present a case of a chronic grade II MCL sprain successfully treated with percutaneous ultrasonic debridement.

Cost and Treatment Characteristics of Sport-Related Knee Injuries Managed by Athletic Trainers: A Report From the Athletic Training Practice-Based Research Network.

Knee injuries are common during sport participation. However, little is known about the overall management and estimated direct costs of care associated with these injuries when under the care of athletic trainers. To describe the treatment characteristics and direct costs of care for athletic training services provided for patients with knee injuries. Descriptive study. Ninety-five athletic training facilities across 24 states. A total of 117 athletic trainers (females = 56.4%, age = 29.4 ± 8.7 years, years certified = 4.7 ± 6.0, years employed at site = 1.6 ± 4.1). Complete patient cases were identified using International Classification of Disease-10 diagnostic codes between 2009 and 2020. Summary statistics were calculated for patient demographics, treatment characteristics, and direct costs of care. Treatment characteristics included the type of athletic training service, duration, amount (eg, number of visits), and direct costs of care. A total of 441 patient cases were included. The most common injuries reported were cruciate ligament sprain (18.1%, n = 80), medial collateral ligament sprain (15.4%, n = 68), and knee pain (14.1%, n = 62). Injuries occurred most frequently during football (35.4%, n = 156), basketball (14.7%, n = 65), and soccer (12.7%, n = 56). A total of 8484 athletic training services were recorded over 4254 visits, with therapeutic exercise (29.8%, n = 2530), hot or cold pack (25.8%, n = 2189), and therapeutic activities (11.2%, n = 954) being the most frequently reported services. The median duration of care was 23 days and number of visits was 8. The median total cost of care was $564 per injury and $73 per visit. Patients with knee injuries demonstrated greater time loss than those with other lower extremity injuries. Thus, it is unsurprising that knee injuries were associated with a longer duration and higher cost of care than other lower extremity injuries such as ankle sprains. Future researchers should examine the effectiveness of common treatment strategies and aim to identify treatments that can reduce costs and improve patient outcomes.

Chronic Medial Collateral Ligament Sprain and Medial Collateral Ligament Bursitis of the Knee in a Female Soccer Player: A Case Report

Chronic Medial Collateral Ligament Sprain and Medial Collateral Ligament Bursitis of the Knee in a Female Soccer Player: A Case Report

Determination of Effect of Platelet Rich Plasma Injection on Improving Pain and Function in Young Healthy Athletes with Isolated Grade 2 or 3 Knee Medial Collateral Ligament Sprains

Background: Knee medial collateral ligament (MCL) sprain is common in athletes, which keeps them away from trainings. Platelet-rich plasma (PRP) injection is used as an adjunct for treatment of musculoskeletal injuries. This study was supposed to define effect of PRP injection on high-grade MCL sprain healing, in comparison to rehabilitation alone. M aterials and Methods: This study was performed on 46 healthy athletes with high-grade MCL sprains who came to sports medicine clinic of Taleghani Hospital, Tehran over a one-year period (2017-2018). In first visit injury grade, its location, baseline pain, Lysholm score and joint stability was determined. Participants randomly allocated to 2 groups (n=23), “group A” had 12-week functional rehabilitation and “group B” had the same rehabilitation plus a single PRP injection. At 4-week intervals valgus stress testing, pain and Lysholm scores was reassessed. The scores of 4 th , 8 th and 12 th weeks was compared to the baseline scores. R es ults: Mean baseline pain score in control and intervention group was 5.09±0.949 and 5.26±0.810 respectively that in the fourth week of study reduced to 1.30±0.765 and 2.43±0.507 (p<0.001). In intervention group, fourth week pain was significantly reduced while stability and Lysholm scores of the groups had no significant difference. C onclusion: PRP injection had a short-term statistically significant pain reduction effect that may assist in faster rehabilitation progress, shorter return to play and less detraining which is crucial to professional athletes.

Primary Repair of the Medial Collateral Ligament with a Double Row Suture Technique and Suture Tape Augmentation for Acute Tibial-Sided Injuries

The management of medial collateral ligament (MCL) injuries has evolved during the past 30 years. Most heal reliably with conservative management. The treatment of MCL sprains with concomitant other ligamentous injuries continues to be controversial. Surgical management of chronic laxity of the medial structures can be quite difficult, and therefore anatomic repair of the medial support structures in the acute setting is preferred when indicated. Complete avulsion of the superficial and deep MCL from the tibia with disruption of the meniscal coronary ligament have a poor prognosis with non-operative treatment and may be optimally managed with acute surgical repair for improved valgus stability. A recent review demonstrated that there is a role for primary MCL repair for select patients. This technique addresses complete avulsions from the tibia, using multiple anchors for anatomic reattachment of the deep and superficial MCL, SutureBridge construct to enhance footprint compression, and suture tape to augment the MCL repair. Advantages of this technique include utilization of suture tape augmentation to allow for early range of motion, maintenance of the native MCL to preserve proprioception, and repair in the acute setting for faster recovery.

Common injuries among javelin throwers: a 10-year overview (2007-2016)

The sport of javelin throwing is a popular track and field competition enjoyed by many spectators and athletes and performed at both national and international levels. It has gained popularity in the IAAF (International Association of Athletics Federation) recognised competitions including the Olympic Games. Like athletes in all sports, javelin throwers are prone to injuries. This review was undertaken to provide an overview of the common javelin throwing injuries recorded internationally during 2007 to 2016. A systematic review of literature following the PRIMSA guidelines from 2007 to 2016 was used. Records were appraised according to the modified Downs and Black Appraisal Scale. The literature review identified 1710 English records. After the application of the exclusion criteria, 12 papers were included in the study. Javelin throwers experience a high prevalence of shoulder, elbow, lower back and knee injuries. The most common type of injury was the medial ulnar collateral ligament sprain, commonly known as javelin thrower’s elbow. The primary cause of injuries was poor throwing biomechanics that led to compensatory movement patterns, resulting in synergistic muscle dominance. The need for prospective studies is recommended.Keywords: Javelin throw, injuries, biomechanics.

Exploration d’une instabilité chronique du genou

Chronic knee instability is a very common reason for consultation in orthopaedics, most often after injury reported by the patient. Physical examination has an important place for the diagnostic approach. Previous patient history, type of trauma are also important as well as initial hemarthrosis, ligament testing and patellar tracking. Further investigations (X-rays and MRI) enable to confirm clinical diagnosis and to analyse associated lesions (meniscus, cartilage). Instability as the main symptom may cover numerous etiologies. Knee instability may be observed in the frontal or sagittal plan or both. There are several grades of severity from the common medial collateral ligament sprain to the complete tear of the anterior cruciate ligament or even knee dislocation. The term instability also includes the patellar dislocations, the most serious stage of the femoropatellar instability. Once the type of instability defined and the anatomical lesions identified, the treatment will be selected for each patient; it may be functional, medical or surgical, according to the types of lesion, age and physical activity, motivation and patient discomfort. It is important to be aware of the natural outcome of these instabilities in order to prevent lesions leading to osteoarthritis (OA).

Injuries in women's international ice hockey: an 8-year study of the World Championship tournaments and Olympic Winter Games

BackgroundWe report the incidence, type, mechanism and severity of ice hockey injuries in women's international ice hockey championships.MethodsAll injuries in the International Ice Hockey Federation World Women's Championship, World Women's...

Caring for Wrestlers.

Wrestling is a popular high school and college sport with an injury and illness rate second only to football. It is important that the physician providing medical care for wrestlers be familiar with the unique characteristics of wrestling and the associated common injuries and medical problems. Common orthopedic injuries include shoulder, elbow, and finger dislocation; prepatellar bursitis; knee medial collateral ligament sprains; and cervical strains. Skin infections are the most common cause of missed mat time for wrestlers. Physicians need to be able to identify and treat these infections, and know the rules regarding return to wrestling once an infection has been identified. Other conditions that are common include auricular hematomas, epistaxis, and brow lacerations. Physicians also need to be familiar with the medical issues involved with rapid weight loss and weight cycling, and understand the high school and college weight certification rules.

The Epidemiology of Medial Collateral Ligament Sprains in Young Athletes

Background: A medial collateral ligament (MCL) knee sprain is a prevalent injury in athletic populations that may result in significant time lost to injury. Remarkably little is known of the epidemiology of this injury. Purpose: To define the incidence of MCL tears and to determine the demographic and athletic risk factors. Study Design: Descriptive epidemiological study. Methods: A longitudinal cohort study was performed to examine the epidemiology of isolated MCL sprains at the United States Military Academy (USMA) between 2005 and 2009. Charts and radiographic studies were reviewed by an independent orthopaedic surgeon to identify all new isolated MCL sprains resulting in time lost to sport and activity that occurred within the study period. Incidence rates (IRs) with 95% confidence intervals (CIs) were calculated per 1000 person-years at risk and by sex, sport, and level of competition. The IR per 1000 athlete-exposures (AEs) was also determined. Incidence rate ratios (IRRs) and respective 95% CIs were calculated between male and female students, intercollegiate and intramural athletes, and male and female intercollegiate athletes involved in selected sports. Chi-square and Poisson regression analyses were used to examine the relationship between the variables of interest and the incidence of MCL sprains, with statistical significance set at P < .05. Results: A total of 128 cadets sustained isolated MCL injuries during 17,606 student person-years from 2005 to 2009. This resulted in an IR of approximately 7.3 per 1000 person-years. Of the 128 injuries, 114 were in male athletes (89%) and 14 were in female athletes (11%). Male cadets had a 44% higher IR than did female cadets (7.60 vs 5.36, respectively), although this was not significant (P = .212). Of 5820 at-risk intercollegiate athletes, 59 (53 male, 6 female) sustained an isolated MCL sprain during 528,523 (407,475 male, 121,048 female) AEs for an overall IR of 10.14 per 1000 person-years and 0.11 per 1000 AEs. The IRR of MCL sprains of men compared with women involved in intercollegiate athletics was 2.87 (95% CI, 1.24-8.18) per 1000 person-years and 2.62 (95% CI, 1.13-7.47) per 1000 AEs. Of 21,805 at-risk intramural athletes, with quarterly participation, 16 (all male) sustained isolated MCL injuries during 225,683 AEs for an overall IR of 0.07 per 1000 AEs. The IRs of MCL injuries of intercollegiate and intramural athletes did not differ significantly. In intercollegiate sports, wrestling (0.57), judo (0.36), hockey (0.34), and rugby (men’s, 0.22; women’s, 0.23) had the highest IRs per 1000 AEs. When examining men’s intercollegiate athletics, the IRRs of wrestling (13.41; 95% CI, 1.80-595.27) and hockey (8.12; 95% CI, 0.91-384.16) were significantly higher compared with that of lacrosse. Among women’s intercollegiate sports as well as intramural sports, there were no significant differences in IRs. A median of 16 days was lost to injury, with 2407 total days lost for all injuries. Grade 1 MCL injuries lost a median of 13.5 days, while higher grade injuries lost a median of 29 days. Conclusion: Medial collateral ligament injuries are relatively common in athletic cohorts. The most injurious sports are contact sports such as wrestling, hockey, judo, and rugby. Male athletes are at a greater risk than female athletes. Intercollegiate athletes are at a greater risk than intramural athletes. The average amount of time lost per injury was 23.2 days, with greater time lost with higher grade sprains than grade 1 sprains.

Validity and Reliability of the Standardized Orthopedic Assessment Tool (SOAT): A Variation of the Traditional Objective Structured Clinical Examination

Health care professions have replaced traditional multiple choice tests or essays with structured and practical, performance-based examinations with the hope of eliminating rater bias and measuring clinical competence. To establish the validity and reliability of the Standardized Orthopedic Assessment Tool (SOAT) as a measure of clinical competence of orthopaedic injury evaluation. Descriptive laboratory study. University. A total of 60 undergraduate students and 11 raters from 3 Canadian universities and 1 standardized patient. Students were required to complete a 30-minute musculoskeletal evaluation in 1 of 2 randomly assigned mock scenarios involving the knee (second-degree medial collateral ligament sprain) or the shoulder (third-degree supraspinatus muscle strain). We measured interreliability with an intraclass correlation coefficient (ICC) (2,k) and stability of the tool with standard error of measurement and confidence intervals. Agreement was measured using Bland-Altman plots. Concurrent validity was measured using a Pearson product moment correlation coefficient whereby the raters' global rating of a student was matched to the cumulative mean grade score. The ICCs were 0.75 and 0.82 for the shoulder and knee cases, respectively. Bland-Altman plots indicated no systematic bias between raters. In addition, Pearson product moment correlation analysis demonstrated a strong relationship between the overall cumulative mean grade score and the global rating score of the examinees' performances. This study demonstrated good interrater reliability of the SOAT with a standard error of measurement that indicated very modest stability, strong agreement between raters, and correlation indicative of concurrent validity.