UFC fight may have resulted in multi-ligament knee injury, here’s why

A nasty kneebar at last night’s UFC fight night card

Yesterday’s UFC fight Night Kara-France vs, Albazi card featured five finishes, one of which saw Ketlen Souza tapping to a kneebar submission at the hands of Karine Silva in the first round. This submission resulted in an obvious knee injury for Souza. I believe Souza may have suffered a multi-ligament injury.

The video below shows the submission in its entirety.

Deep dive on Ketlen Souza’s potential injury

Here’s why I think this move resulted in a potential multi-ligament injury.

There are two points of interest in this video that explain how at least two of the four critical knee-stabilizing ligaments may have been compromised. First point: the position of the tibia (lower leg) with relation to the femur (thigh). In the screen capture below, the tibia (red arrow) has popped forward, or anteriorly, with respect to the femur, commonly referred to as anterior shear of the tibia.

An important function of the anterior cruciate ligament (ACL)  is to resist this anterior shearing force. So, when the tibia pops out anteriorly as shown here, the immediate concern is that the ACL has been compromised.

Second point- the forced angular position of the knee. In the screen capture below, notice the angle of the knee with the lower leg being forced outward.

This position is referred to as valgus, and places a tremendous stress on the inside of the knee joint. Taken to the extreme, this position can tear the medial collateral ligament (MCL), which is located on the inside (medial) knee. The MCL provides primary stability to the medial knee.

I think the three injury scenarios for Souza include an isolated ACL tear, an isolated MCL tear, or a tear involving both ligaments. Other possibilities include injury to the lateral collateral ligament (LCL), as well as the meniscus within the knee. I think this scenario is less likely, and hopefully these structures are not involved.

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Kevin Nicholson

Kevin is a physical therapist with a special interest in MMA fighter injuries, rehabilitation and recovery.

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