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Comprehensive PCL lesion workup may identify concomitant injuries in NFL players

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A complete comprehensive workup of athletes who participated in the National Football League Combine, including plain and PCL stress view radiographs and MRI, in instances where there was clinical concern about PCL ligamentous laxity, may help identify concomitant injuries, according to results published in Arthroscopy.

“The take home message of this study is that, particularly in cases involving high-level athletes with clinical concern for PCL ligamentous laxity, there should be a complete comprehensive workup that includes plain and PCL stress view radiographs, and MRI to detect all possible concomitant injuries,” Matthew T. Provencher, MD, CAPT, MC, USNR, of The Steadman Philippon Research Institute, told Orthopedics Today. “Considering the presence of associated lesions, time elapsed since injury, severity of the lesion (grade) and time of the season, isolated acute low-grade lesions should be typically managed with a nonoperative approach, whereas grade 3/combined/chronic symptomatic lesions are treated surgically.”

To identify PCL injuries that occurred during the NFL combine, Provencher and colleagues compiled the medical and physical performance examination results of 2,285 NFL draftees who participated in the NFL Combine from 2009 to 2015.

PCL injury was identified in 3% of players who participated in the NFL Combine, of which 15.9% were managed surgically. Results showed the most common positions with a PCL injury included running backs (6%) and offensive linemen (4%) followed by defensive linemen (2.5%). Researchers found that 47.7%, 49.2% and 2.9% of players had a grade 1, grade 2 and grade 3 posterior drawer test, respectively.

Running backs and offensive linemen who participated in the NFL Combine from 2009 to 2013 presented more often with PCL tears, like this one, than players in other positions.

Matthew T. Provencher, MD, CAPT, MC, USNR

“Concomitant injuries were present frequently in these cases with the additional pathologies most often being medial collateral ligament (MCL; 42%), ACL (12%) and chondral injuries (32%), especially in the lateral tibiofemoral compartment,” Provencher said. – by Casey Tingle

Logan CA, et al. Arthroscopy. 2018;doi:10.1016/j.arthro.2017.08.304

Matthew T. Provencher, MD, CAPT, MC, USNR, can be reached at 181 W. Meadow Dr., Suite 4000, Vail, CO 81657; email: mprovencher@thesteadmanclinic.com.

Disclosures: Provencher reports he is a paid consultant for Arthrex and JRF Ortho; has patents with the United States of America as Rep. by the Secretary of the Navy and Arthrex; and he receives publishing royalties from Arthrex and SLACK.