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Background
Australia has a high rate of sporting participation. Although this has many benefits, knee injuries are common, particularly in pivoting and contact sports.
Objective
This article reviews the management of common sport-related knee injuries, including injuries to the collateral and cruciate ligaments, menisci and the extensor mechanism.
Discussion
Some sport-related knee injuries can be treated non-operatively with physiotherapy-led rehabilitation. These include the majority of isolated medial collateral ligament, lateral collateral ligament and posterior cruciate ligament injuries. Other knee injuries might require surgical intervention. These include anterior cruciate ligament ruptures in young patients aiming to return to pivoting sports, certain meniscal tears and extensor mechanism disruptions. A multidisciplinary approach to these injuries will facilitate optimal patient care.
SPORT is incredibly popular in Australia, with over half the nation's population participating in sporting activities each year.1 Although this has many benefits for physical and mental health, knee injuries are common, particularly in pivoting and contact sports, such as Australian rules football, rugby league, rugby union, touch football, netball, soccer and basketball. Australia has the highest rate of anterior cruciate ligament (ACL) reconstruction in the world.2 Athletes who injure their knee are at increased risk of knee osteoarthritis at a younger age.3 Management ranges from simple first aid and bracing through to complex surgical reconstruction, but should always include supervised rehabilitation as well as individualised strategies to promote lifelong engagement in exercise and osteoarthritis risk reduction.4
Aim
The aim of this review is to summarise the management of common sporting knee injuries, including injuries to the collateral and cruciate ligaments, menisci and the extensor mechanism. Key findings on history, examination and imaging are highlighted, and treatment options are discussed.
Common acute sport-related knee injuries
Collateral ligament injuries
The medial collateral ligament (MCL) is commonly injured when a valgus (lateral to medial) force is applied to the knee.5 Patients typically present with medial knee pain and might have difficulty weight bearing (Box 1). Examination involves applying a valgus force to the knee with the joint held at 30° of flexion (Figure 1A) and then in full extension. MCL injuries can be graded according to Table 1. Laxity in extension implies damage to other structures, for example the ACL or posterior cruciate ligament (PCL). Magnetic resonance imaging (MRI)...