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Treatment of Isolated Medial Collateral Ligament Injuries in Athletes with Early Functional Rehabilitation

A Five-year Follow-up Study

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Michael R. Sathy, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

James Talkington, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Nestor Blyznak, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Stephen Kollias, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

A prospective study was designed to provide 5-year fol lowup of the treatment of isolated grade I I I sprains of the medial collateral ligament with early functional rehabili tation in 35 athletes. After injury, patients were placed in lateral hinged braces to provide valgus support with out restricting flexion or extension of the knee. Treat ment was initiated with range of motion exercises per formed in a whirlpool or swimming pool. Patients were then started on quadriceps setting and leg raises. When 90° of flexion was present, resistive exercises were added. Upon recovery, patients were allowed to return to unrestricted sports. Followup consisted of both ques tionnaires and physical examination and was graded on the 50-point Hospital for Special Surgery scale. Mean followup was 5.3 years (range, 2.5 to 8); mean Hospital for Special Surgery knee rating score was 45.9 points (range, 41 to 50). These results are comparable with those achieved with surgery or immobilization by earlier investigators. Thus, early functional rehabilitation treat ment of complete medial collateral ligament sprains pro duces results comparable with those achieved with sur gery or immobilization while minimizing treatment- related morbidity and allowing more rapid return to sports participation.

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