A rather trivial question for docs regarding Romney's injury...

[statman]

I read the press release, and it said he was having surgery to repair torn ACL & LCL. How likely is it that he tore the MCL as well? The little known fact being that the MCL usually repairs itself (my wife completely tore her ACL & MCL, and they only touched the MCL to clean up a little scar tissue that had formed in the 6 weeks between injury and surgery. By then, the MCL had knitted back together and required only some touch-up to ensure a speedy recovery.). ACLs & LCLs, on the other hand, don't have enough blood-supply to repair themselves.

I'm assuming he probably tore all three. Is that a bad assumption?

[ERCougar]

I read the press release, and it said he was having surgery to repair torn ACL & LCL. How likely is it that he tore the MCL as well? The little known fact being that the MCL usually repairs itself (my wife completely tore her ACL & MCL, and they only touched the MCL to clean up a little scar tissue that had formed in the 6 weeks between injury and surgery. By then, the MCL had knitted back together and required only some touch-up to ensure a speedy recovery.). ACLs & LCLs, on the other hand, don't have enough blood-supply to repair themselves.

I'm assuming he probably tore all three. Is that a bad assumption?

This one's for hostile, but I'd be surprised if he tore the ACL and LCL--that's an odd combo. Much morelikely to be the ACL/MCL.

[statman]

This one's for hostile, but I'd be surprised if he tore the ACL and LCL--that's an odd combo. Much morelikely to be the ACL/MCL.

This is where I read it: http://www.byucougars.com/Filing.jsp?ID=14424

They specifically mention ACL & LCL as both requiring surgery. We agree that ACL & LCL is a strange combo - the MCL is between them - and from what I understand is usually the first one of the three to go. If the ACL & LCL are both torn, dollars to donuts the MCL is as well...

[Jarid in Cedar]

given the mechanism of injury, MCL-ACL would be more likely. an LCL would require at least some vargus force

[creekster]

given the mechanism of injury, MCL-ACL would be more likely. an LCL would require at least some vargus force

I know you're not, but it sounds like oyu are making that up just to impress us.

[Jarid in Cedar]

I know you're not, but it sounds like oyu are making that up just to impress us.

I am not making it up, but maybe I am trying to impress you just a little

[doctorcoug]

Looking at the video, I don't get how the LCL tore. Maybe that is why I'm not an orthopod

[hostile]

I read the press release, and it said he was having surgery to repair torn ACL & LCL. How likely is it that he tore the MCL as well? The little known fact being that the MCL usually repairs itself (my wife completely tore her ACL & MCL, and they only touched the MCL to clean up a little scar tissue that had formed in the 6 weeks between injury and surgery. By then, the MCL had knitted back together and required only some touch-up to ensure a speedy recovery.). ACLs & LCLs, on the other hand, don't have enough blood-supply to repair themselves.

I'm assuming he probably tore all three. Is that a bad assumption?

I've watched the video and at first glance it appears that the direction of force is from the lateral (outside) aspect of the leg/knee which would result in a valgus (you almost got it JIC) force through the knee joint.

This typically results in an injury to the MCL, and if there is enough force can rupture the ACL.

Closer inspection looks like the leg/knee is hit from the back and side of the leg with a planted foot. This could drive the tibia forward in relation to the femur and rupture the ACL. Once ruptured, the tibia likely continued to rotate internally on the medial (inside) aspect of the femur and damaged the LCL. Given that mechanism, I would not be surprised if he has also injured the posterolateral corner of the knee.

ACL injuries really don't heal due to the poor blood supply and intraarticular fluid around the torn tendon ends. LCL injuries tend to not heal as well as MCL's. If severe enough, they are treated with surgery.

This really sucks for Fuga. I hope he can make it back.

[myboynoah]

I know you're not, but it sounds like oyu are making that up just to impress us.

Yeah, he had me until he threw in that "vargus force" stuff.

Who talks like that? I'm a simpleton. Talk down to me.

[Jarid in Cedar]

Yeah, he had me until he threw in that "vargus force" stuff.

Who talks like that?

I've watched the video and at first glance it appears that the direction of force is from the lateral (outside) aspect of the leg/knee which would result in a valgus (you almost got it JIC) force through the knee joint.

...

[statman]

I've watched the video and at first glance it appears that the direction of force is from the lateral (outside) aspect of the leg/knee which would result in a valgus (you almost got it JIC) force through the knee joint.

This typically results in an injury to the MCL, and if there is enough force can rupture the ACL.

Closer inspection looks like the leg/knee is hit from the back and side of the leg with a planted foot. This could drive the tibia forward in relation to the femur and rupture the ACL. Once ruptured, the tibia likely continued to rotate internally on the medial (inside) aspect of the femur and damaged the LCL. Given that mechanism, I would not be surprised if he has also injured the posterolateral corner of the knee.

ACL injuries really don't heal due to the poor blood supply and intraarticular fluid around the torn tendon ends. LCL injuries tend to not heal as well as MCL's. If severe enough, they are treated with surgery.

This really sucks for Fuga. I hope he can make it back.

So you think it's all three?

[hostile]

So you think it's all three?

It is possible, but rare, to injure just the ACL and LCL. It looked to me, from the video, that the ground stopped the knee from traveling further and may have prevented and MCL injury. He may have a minor MCL injury, but that won't be the determining factor in his treatment and recovery.

[wuapinmon]

I've watched the video and at first glance it appears that the direction of force is from the lateral (outside) aspect of the leg/knee which would result in a valgus (you almost got it JIC) force through the knee joint.

This typically results in an injury to the MCL, and if there is enough force can rupture the ACL.

Closer inspection looks like the leg/knee is hit from the back and side of the leg with a planted foot. This could drive the tibia forward in relation to the femur and rupture the ACL. Once ruptured, the tibia likely continued to rotate internally on the medial (inside) aspect of the femur and damaged the LCL. Given that mechanism, I would not be surprised if he has also injured the posterolateral corner of the knee.

ACL injuries really don't heal due to the poor blood supply and intraarticular fluid around the torn tendon ends. LCL injuries tend to not heal as well as MCL's. If severe enough, they are treated with surgery.

This really sucks for Fuga. I hope he can make it back.

Poor kid. That has to hurt like hell.

[bluegoose]

Go watch the video again, guys. He was hit from the left but he injured the right knee. The left knee, the one that appears to have sustained the impact, looks to be totally fine. In the youtube videos in the other thread, his right knee was being tended to and while walking off the field he was favoring the right leg.

It was a varus force injury, with a posterior/lateral impact. It would be consistent with an LCL and ACL injury. I think the reports of the torn ligaments are correct and it is likely that that MCL was spared, fwiw.

[hostile]

Go watch the video again, guys. He was hit from the left but he injured the right knee. The left knee, the one that appears to have sustained the impact, looks to be totally fine. In the youtube videos in the other thread, his right knee was being tended to and while walking off the field he was favoring the right leg.

It was a varus force injury, with a posterior/lateral impact. It would be consistent with an LCL and ACL injury. I think the reports of the torn ligaments are correct and it is likely that that MCL was spared, fwiw.

good point. i didn't even pay attention to which leg was mentioned as the injured one - i assumed it was the left. Looking at the video, how could the L knee not be injured? If the R knee is injured then the mechanism fits with an ACL/LCL injury and varus force to the R knee.

EDIT: It also looks like he has a brace on the L knee, but not on the R.