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Nonoperative Treatment for Partial Ruptures of the Lateral Collateral Ligament Occurring in Combination With Complete Ruptures of the Anterolateral Ligament: A Common Injury Pattern in Brazilian Jiu-Jitsu Athletes With Acute Knee Injury.

ABSTRACT: Background:Combined partial lateral collateral and complete anterolateral ligament (PLCCALL) injuries are a specific injury pattern seen in Brazilian jiu-jitsu (BJJ) because of the knee varus-flexion mechanism that frequently occurs during grappling. Purpose/Hypothesis:The purpose of this study was to evaluate the incidence of this injury pattern in a series of BJJ athletes with an acute knee injury and to evaluate clinical and functional outcomes after nonoperative management at a minimum follow-up of 1 year. Our hypotheses were that PLCCALL injuries are common in BJJ and that nonoperative treatment is associated with excellent clinical outcomes and return to the preinjury level of sport. Study Design:Case series; Level of evidence, 4. Methods:All BJJ athletes who presented with an acute knee injury between July 2013 and June 2017 and who underwent magnetic resonance imaging (MRI) of the knee were included. A specific emphasis was placed on identifying those whose imaging demonstrated PLCCALL injury. Clinical evaluation included physical examination as well as Lysholm and International Knee Documentation Committee (IKDC) scores. Results:Of the 27 patients analyzed, 7 (25.9%) had MRI-proven PLCCALL injuries. The mean follow-up after nonoperative management was 41.3 months. The mean IKDC and Lysholm scores were 94 and 92 before the injury, 26 and 36 at the initial assessment after the injury, and 83 and 78 at 12-month follow-up, respectively (P < .00001). All 7 patients had returned to their preinjury level of sports by the 12-month follow-up. The mean time between injury and return to competition level was 4.7 months (range, 4-6 months). Conclusion:PLCCALL injury is a specific but infrequent injury pattern in BJJ. The prognosis of this injury after nonoperative treatment appears to be excellent. Improved functional scores (IKDC and Lysholm) and changes on MRI demonstrated that the anterolateral ligament has intrinsic healing potential, as the images showed complete healing of the previously documented rupture of the anterolateral ligament from its proximal attachment.

SUBMITTER: Temponi EF

PROVIDER: S-EPMC6348520 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Nonoperative Treatment for Partial Ruptures of the Lateral Collateral Ligament Occurring in Combination With Complete Ruptures of the Anterolateral Ligament: A Common Injury Pattern in Brazilian Jiu-Jitsu Athletes With Acute Knee Injury.

Temponi Eduardo Frois EF Saithna Adnan A de Carvalho Lúcio Honório LH Teixeira Bruno Presses BP Sonnery-Cottet Bertrand B

Orthopaedic journal of sports medicine 20190124 1

<h4>Background</h4>Combined partial lateral collateral and complete anterolateral ligament (PLCCALL) injuries are a specific injury pattern seen in Brazilian jiu-jitsu (BJJ) because of the knee varus-flexion mechanism that frequently occurs during grappling.<h4>Purpose/hypothesis</h4>The purpose of this study was to evaluate the incidence of this injury pattern in a series of BJJ athletes with an acute knee injury and to evaluate clinical and functional outcomes after nonoperative management at ...[more]

PMID: 30719481

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Project description:BackgroundBrazilian jiu-jitsu (BJJ) is a grappling-based martial art that can lead to injuries both in training and in competition. There is a paucity of data regarding injuries sustained while training in BJJ, in both competitive and noncompetitive jiu-jitsu athletes.HypothesisWe hypothesize that most BJJ practitioners sustain injuries to various body locations while in training and in competition. Our primary objective was to describe injuries sustained while training for BJJ, both in practice and in competition. Our secondary objectives were to classify injury type and to explore participant and injury characteristics associated with wanting to quit jiu-jitsu after injury.Study designDescriptive epidemiology study.MethodsWe conducted a survey of all BJJ participants at a single club in Hamilton, Ontario, Canada. We developed a questionnaire including questions on demographics, injuries in competition and/or training, treatment received, and whether the participant considered discontinuing BJJ after injury.ResultsA total of 70 BJJ athletes participated in this study (response rate, 85%). Ninety-one percent of participants were injured in training and 60% of competitive athletes were injured in competitions. Significantly more injuries were sustained overall for each body region in training in comparison with competition (P < 0.001). Two-thirds of injured participants required medical attention, with 15% requiring surgery. Participants requiring surgical treatment were 6.5 times more likely to consider quitting compared with those requiring other treatments, including no treatment (odds ratio [OR], 6.50; 95% CI, 1.53-27.60). Participants required to take more than 4 months off training were 5.5 times more likely to consider quitting compared with those who took less time off (OR, 5.48; 95% CI, 2.25-13.38).ConclusionThe prevalence of injury is very high among BJJ practitioners, with 9 of 10 practitioners sustaining at least 1 injury, commonly during training. Injuries were primarily sprains and strains to fingers, the upper extremity, and neck. Potential participants in BJJ should be informed regarding significant risk of injury and instructed regarding appropriate precautions and safety protocols.Clinical relevanceClinicians should be aware of the substantial risk of injury among BJJ practitioners and the epidemiology of the injuries as outlined in this article.

Project description:BACKGROUND:Brazilian jiu-jitsu is a grappling combat sport that has intermittency as its core element; in other words, actions of high, moderate and low intensity are interspersed during matches, requiring a high level of conditioning to support optimal levels of performance for the total match time. The athletes perform from four to six matches during a day of competition, and this number may increase if the open-class competition, which is held parallel to the competition by weight class, is considered. This systematic review examined the physical and physiological profiles of Brazilian jiu-jitsu athletes. METHODS:Only scientific researches dealing with the major fitness components of Brazilian jiu-jitsu athletes (i.e. body composition and somatotype, aerobic and anaerobic profiles, muscular strength and power) and using accepted methods that provided relevant practical applications for a Brazilian jiu-jitsu athlete's fitness training and/or performance were included in the current review. A computer literature search was carried out of the PubMed, ISI Web of Knowledge, SportDiscus and Scopus databases (up to January 2016). RESULTS:The database research generated 205 articles. After the application of inclusion and exclusion criteria, 58 studies were included for the present systematic review. A total of 1496 subjects were involved in all the selected investigations. CONCLUSIONS:Body fat is generally low for these athletes and the mesomorphic component is predominant. The different studies showed VO2max values between 42 and 52 mL/kg/min, and it seems that aerobic fitness does not discriminate among Brazilian jiu-jitsu athletes of different competitive levels. There is a lack of scientific studies that have investigated anaerobic responses both in lower and upper limbs. Maximal dynamic, isometric and endurance strength can be associated with sporting success in Brazilian jiu-jitsu athletes. Although decisive actions during Brazilian jiu-jitsu matches are mainly dependent on muscular power, more specific studies are necessary to describe it. Studies involving the female sex should be conducted. In addition, further research is needed to analyse whether there are differences between sex, belt ranks and competitive level, and among the different weight categories for different variables.

Project description:BackgroundBrazilian jiu jitsu (BJJ) is a growing martial art that focuses on grappling techniques.PurposeTo quantify the 3-year incidence of BJJ-related injuries and detect common injury patterns as well as risk factors among those practicing BJJ. It was hypothesized that there would be a high incidence of injuries, they would be caused by submissions in sparring situations, and they would occur predominantly at the extremities.Study designDescriptive epidemiology study.MethodsActive BJJ athletes were invited to take an English-language online survey developed by orthopaedic surgeons together with BJJ athletes and a sports scientist. Data were recorded regarding athlete demographics, sporting activity level, injuries within the past 3 years that caused at least a 2-week time loss, injury mechanisms, and return to sport.ResultsOverall, 1140 responses were received from 62 different countries; 88.9% of all athletes were male, and 63.9% were regular competitors. Within the investigated cohort, 1052 injuries were recorded in 784 athletes, for an injury incidence of 308 per 1000 athletes per year. The lower extremity (45.7%) and upper extremity (30.2%) were predominant sites of injury, with injuries to the knee (27.1%) being the most common. The most frequent knee injuries were meniscal injuries (n = 65), anterior cruciate ligament (ACL) tears (n = 36), and medial collateral ligament injuries (n = 36). ACL tears were especially associated with long time frames for return to sport. Most injuries occurred during sparring (77.6%) and were caused by submissions (29.7%) and takedowns (26.4%). Competing regularly (P = .003), older age (P < .001), and higher belt rank (P = .003) were significant risk factors for injury.ConclusionInjury incidence was high among BJJ athletes surveyed, with 2 out of 3 athletes reporting at least 1 injury within a 3-year period that caused a 2-week absence from training. Most injuries occurred during sparring, and we believe that a high potential for injury reduction lies in drawing awareness to common injury patterns and sites in athletes.

Dataset Information

Nonoperative Treatment for Partial Ruptures of the Lateral Collateral Ligament Occurring in Combination With Complete Ruptures of the Anterolateral Ligament: A Common Injury Pattern in Brazilian Jiu-Jitsu Athletes With Acute Knee Injury.

Publications

Nonoperative Treatment for Partial Ruptures of the Lateral Collateral Ligament Occurring in Combination With Complete Ruptures of the Anterolateral Ligament: A Common Injury Pattern in Brazilian Jiu-Jitsu Athletes With Acute Knee Injury.

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