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Knee Injury Mechanism Varies by Injury Category

Strategic Insights

— 1 min read

Research from the University of Nebraska Medical Center sheds light on the various mechanisms of multi-ligament knee injuries (MLKIs) sustained during National Football League (NFL) games. A retrospective video analysis of official NFL game footage from 1997 to 2022 revealed significant differences in injury patterns and mechanisms. The study identified 35 MLKIs, with the majority occurring due to direct contact to the limb. The most common combination of ligament injuries was to the anterior cruciate ligament (ACL) and medial collateral ligament (MCL).

Key Takeaways:

  • MLKIs most commonly occurred from direct contact to the limb (80%), with indirect contact being the second most common mechanism (14.3%).
  • The most common MLKI was injury to the ACL and MCL (65%), while the second most common was the ACL and lateral collateral ligament (LCL) (15%).
  • Direct contact MLKI most often resulted in a valgus and external rotational force about a flexed knee (58%).
  • There were statistically significant differences when comparing the direction of contact, hip, and knee position between injury MLKI groups.
  • Combined ACL and MCL injury commonly occurs with knee flexion, valgus, and external rotation.
  • Multiligament injuries involving three ligaments occurred only from direct contact mechanisms.

Statistics:

  • 35 MLKIs were identified during the retrospective video analysis.
  • 80% of MLKIs occurred due to direct contact to the limb.
  • 14.3% of MLKIs occurred due to indirect contact.
  • The ACL and MCL was the most common combination of ligament injuries (65%).
  • The ACL and LCL was the second most common combination of ligament injuries (15%).
  • 58% of direct contact MLKIs resulted in a valgus and external rotational force about a flexed knee.

Sources:

  • NewsRx. Findings from University of Nebraska Medical Center Has Provided New Information about Knee Injury (Knee injury mechanism varies by injury category: Video analysis of multi-ligament knee injuries in the National Football League). Health & Medicine Week. September 19, 2025; p 1295.
  • Knee Surgery, Sports Traumatology, Arthroscopy. Knee injury mechanism varies by injury category: Video analysis of multi-ligament knee injuries in the National Football League, 2025.

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