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Knee News

Cause and Cure for Combined Knee-Ligament Injuries in Skiers

More and more people are enjoying the ski slopes. Fifteen million people of all ages in the United States ski every year. Along with this increased ski activity, there are increases in ski injuries. Fewer ankle injuries occur now with the newer and better ski equipment. However, the equipment improvements haven't stopped knee injuries.

Damage to the knee occurs in one-third of all ski-related injuries. Many injuries affect more than one structure in the knee. For example, the number of ski injuries involving more than two knee ligaments tripled between 1980 and 1995. The cause and treatment of these "combined ligament injuries" is the subject of this study.

The authors review many ways a skier can lose control and injure the knee. For example, a twisting motion along with force against the outside of the joint is most likely to cause damage to both the anterior cruciate ligament (ACL) and the meniscus (knee cartilage).

The skier is at greater risk for injury if he or she shifts weight too far forward or back over the skis. The ski can become a lever arm that puts too much force on the ligaments. If the boot bindings don't release or the ski doesn't fall off, serious injury can occur. One or more ligaments may be damaged.

The best treatment for combined knee ligament injuries is something of a puzzle for doctors. What to do and when to do it are the subjects of this report when the ACL and the medial collateral ligament (MCL) are both torn.

Nonsurgical treatment for a partial MCL tear is first. These doctors suggest keeping the knee from moving for two weeks by using a splint or brace to hold it in place. Immobilization is followed by early range-of-motion exercises with a protective knee brace. When the patient has full motion and good strength without swelling, the ACL can be repaired. These decisions are based on the severity of the tear. A partial tear may be treated differently than a full tear.


Ari Pressman, MD, and Donald H. Johnson, MD, FRCSC. A Review of Ski Injuries Resulting in Combined Injury to the Anterior Cruciate Ligament and Medial Collateral Ligaments. In Arthroscopy. February 2003. Vol. 19. No. 2. Pp. 194-202.

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