Knee injury in skiing. A multifaceted approach

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanics

Background:

• Skiing is a popular winter sport associated with a significant risk of lower extremity injuries.
• Knee ligament injuries, especially medial collateral ligament (MCL) sprains, are common among skiers.

Purpose of the Study:

• To prospectively evaluate the incidence and characteristics of ski injuries over four seasons.
• To identify risk factors associated with medial collateral ligament sprains in skiers.
• To assess the effectiveness of current ski boot binding technology in preventing knee injuries.

Main Methods:

• Prospective evaluation of 1,141 ski injuries at a northern Vermont ski area over four seasons.
• Analysis of injury data, including ligament involvement, sprain severity, and demographic factors.
• Review of biomechanical forces causing MCL sprains and evaluation of ski binding release mechanisms.

Main Results:

• Knee ligament injuries accounted for 21.6% of all ski injuries, with MCL sprains comprising 18.6%.
• Females had a higher incidence of Grade I MCL sprains, but similar rates of severe sprains compared to males.
• Smaller, younger, less experienced, and less skilled skiers were more prone to Grade I MCL injuries.
• Complete MCL tears were not associated with smaller stature, younger age, or lower skill/experience levels.

Conclusions:

• Medial collateral ligament sprains are frequently caused by external rotation and valgus forces during skiing.
• Current two-mode release ski boot bindings are insufficient in preventing knee sprains due to limitations in release configurations.
• Advanced ski boot bindings with multi-directional release capabilities (roll, shear, twist, forward lean) are necessary for effective knee protection.