| Management of Morel-Lavallee lesion of the knee: twenty-seven cases in the national football league. | |
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MedLine Citation:
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PMID: 17351119 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The Morel-Lavallee lesion is a closed degloving injury most commonly described in the region of the hip joint after blunt trauma. It also occurs in the knee as a result of shearing trauma during football and is a distinct lesion from prepatellar bursitis and quadriceps contusion. PURPOSE: To review the authors' experience with Morel-Lavallee lesion of the knee in the elite contact athlete to construct a diagnostic and treatment algorithm. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Twenty-seven knees in 24 players were identified from 1 National Football League team's annual injury database as having sustained a Morel-Lavallee lesion between 1993 and 2006. Their charts were retrospectively reviewed. RESULTS: The most common mechanism of injury was a shearing blow on the playing surface (81%). The most common motion deficit was active flexion (41%). The mean time for resolution of the fluid collection and achievement of full active flexion was 16.3 days. The mean number of practices missed was 1.5. The mean number of games missed was 0.1. Fourteen knees (52%) were treated successfully with compression wrap, cryotherapy, and motion exercises. Thirteen knees (48%) were treated with at least 1 aspiration, and 6 knees (22%) were treated with multiple aspirations for recurrent serosanguineous fluid collections. In 3 cases (11%), the Morel-Lavallee lesion was successfully treated with doxycycline sclerodesis after 3 aspirations failed to resolve the recurrent fluid collections; return to play was immediate thereafter in each case. CONCLUSION: In football, Morel-Lavallee lesion of the knee usually occurs from a shearing blow from the playing field. Diagnosis is confirmed when examination reveals a large suprapatellar area of palpable fluctuance. Elite athletes are typically able to return to practice and game play long before complete resolution of the lesion. Recurrent fluid collections can occur, necessitating aspiration in approximately half the cases for successful treatment. Recalcitrant fluid collections can be safely and expeditiously treated with doxycycline sclerodesis. |
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Authors:
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Samir G Tejwani; Steven B Cohen; James P Bradley |
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Publication Detail:
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Type: Journal Article Date: 2007-03-09 |
Journal Detail:
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Title: The American journal of sports medicine Volume: 35 ISSN: 0363-5465 ISO Abbreviation: Am J Sports Med Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-06-21 Completed Date: 2007-09-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7609541 Medline TA: Am J Sports Med Country: United States |
Other Details:
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Languages: eng Pagination: 1162-7 Citation Subset: IM |
Affiliation:
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University of Pittsburgh, Center for Sports Medicine, Pittsburgh, Pennsylvania 15203, USA. samtejwani@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Athletic Injuries / etiology, physiopathology, therapy* Cryotherapy Football / injuries* Humans Knee Injuries / diagnosis, etiology, therapy* Male Patella / injuries Retrospective Studies Risk Factors Soft Tissue Injuries / diagnosis, etiology, therapy* Time Factors Treatment Outcome* United States |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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