IC 07-2025 The Collision Course: A Case Based Approach to Management of Complex Injuries in Collision Sport Athletes (CME)-IC 07-2025 The Collision Course: A Case Based Approach to Management of Complex Injuries in Collision Sport Athletes (CME)

Video Transcription

Video Summary

The ICL Collision Course, led by Dr. Gautam Yagnik and esteemed faculty, focused on managing challenging injuries in collision sport athletes, emphasizing the limited evidence-based guidelines in this high-injury-risk population. The session reviewed diverse complex cases, including multiligament knee injuries, recurrent shoulder instability, medial elbow injuries, patellar instability, high-grade AC joint injuries, ACL reruptures with lateral extra-articular tenodesis (LET), and glenoid fractures.<br /><br />One highlighted case involved a severe multiligament knee injury in a collegiate wide receiver with a hyperextension-varus mechanism causing LCL and ACL tears, partial PCL avulsion, and peroneal nerve injury. Surgical strategies discussed included early lateral side repair, ACL reconstruction, and PCL repair augmented with hamstring graft, considering rehabilitation feasibility.<br /><br />Another case showcased recurrent shoulder instability in an edge rusher with a minimal anterior labral tear that was surgically repaired using novel small anchors, followed by reinjury with a "postage stamp" bony Bankart fracture managed with arthroscopic repair supplemented by demineralized bone matrix and PRP, highlighting challenges in fixation and return-to-play timing.<br /><br />A medial elbow UCL peel-off in a quarterback was discussed, weighing conservative versus surgical repair with internal brace augmentation to enable pro day readiness within months, highlighting individualized treatment based on athlete goals.<br /><br />Patellar instability in a defensive lineman involved MPFL reconstruction combined with tibial tubercle osteotomy to address anatomical risk factors and recurrent instability, emphasizing surgical indications in-season.<br /><br />A type III AC joint injury in a collegiate quarterback illustrated conservative management, possible injections, and selective surgical intervention depending on scapulothoracic dysfunction and persistent instability.<br /><br />Finally, a soccer player with ACL rerupture after BTB ACL and LET faced revision with soft tissue quadriceps graft and revision ALL augmentation; notably, a second LET harvest was successfully performed, suggesting feasibility of reusing the IT band.<br /><br />Overall, the course emphasized tailored management, the importance of multidisciplinary collaboration, evolving surgical techniques (including internal bracing and ALL reconstruction), and thoughtful return-to-play decisions based on injury severity, sport, and athlete goals.

Keywords

ICL Collision Course

collision sport injuries

multiligament knee injury

recurrent shoulder instability

medial elbow UCL injury

patellar instability

AC joint injury

ACL rerupture

lateral extra-articular tenodesis (LET)

return-to-play management