Sports injuries are on rise due to increasing awareness and enthusiasm in the younger generation for competitive athletic and gaming activities. They may range from simple muscle strain or sprain to complex ligament tear and bone fracture. The pathology depends on the mechanism of injury whether direct or indirect impact or due to overuse. These injuries gain importance due to the impact on the career of a sports professional. Most commonly knee and shoulder joints are affected.
There are two menisci in the knee which act like cushions. The medial meniscus is most commonly injured due to its limited mobility compared to the lateral one. Meniscus gets damaged commonly due to a twisting injury to the knee. The meniscal tear might be of radial, bucket handle or horizontal type. The treatment depends on the type of tear and zone of injury. The tear might need a repair if it’s in the red zone or partial meniscectomy.
ACL Ligament Tear
Anterior cruciate ligament is torn by twisting injury mostly due to an indirect mechanism. Immediately knee becomes swollen and painful. The emergent treatment would be rest, ice application and analgesics followed by rehabilitation. Most of the cases need arthroscopic ligament reconstruction depending on the symptomatology (instability) and demand activity.
The surgical treatment consists of graft harvesting and arthroscopic reconstruction. The most commonly used grafts are hamstring tendons and Bone Patellar Bone tendon. Postoperative physiotherapy plays a pivotal role in rehabilitation and returns to sports activities.
Rotator Cuff Tear
Rotator cuff includes a group of muscles which help in abduction and external rotation movement of the shoulder. It might get torn as a result of overuse or a sudden fall in young and degeneration in elderly. Acute symptomatology would be severe pain and inability to lift up the shoulder. Clinical evaluation and imaging (MRI or Ultrasound) will help to come to a diagnosis of a partial or complete tear. Most of the tears heal with proper rest and rehabilitation. However, the complete tears or high demand individuals need surgical treatment for restoration to normal.
The surgical treatment consists of reattachment of the rotator cuff to the bone by suture anchors by either arthroscopic or mini-open technique. Postoperative physiotherapy plays a key role in restoration to normal strength.
Bankart's Lesion and Recurrent Dislocation
The shoulder joint is vulnerable to anterior dislocation in forceful abduction and external rotation maneuver which can occur due to fall or contact injury. The pathology consists of avulsion of an anterior and inferior portion of the labrum (soft tissue cushion for deepening the socket of the joint) which often doesn’t heal predisposing to recurrence. This is called Bankart’s lesion. The decision for surgical treatment depends on a number of episodes, an age which predicts recurrence and demand action of the patient.
The surgical treatment consists of reattachment of the avulsed labrum with suture anchors either by arthroscopic technique or mini-open procedure.