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In Street Clothes

Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Understanding Jeremy Lamb’s Knee Injury

The Indiana Pacers were dealt an untimely blow when guard Jeremy Lamb awkwardly fell following a dunk attempt against the Toronto Raptors. Lamb was able to stay in the game and make both his free-throws but it was clear he had sustained a left knee injury as he limped off the court. Unfortunately, additional testing revealed Lamb suffered a significant injury on the play, tearing his anterior cruciate ligament (ACL) and lateral meniscus while also suffering a lateral femoral condyle fracture.

The knee is a hinge joint comprised of multiple stabilizers to protect the overall integrity of the joint, including the two cruciate ligaments (ACL and PCL) and the two collateral ligaments (MCL and LCL). The ACL and PCL work together to limit undue forward and backward motion of the lower leg bone (the tibia) on the upper leg bone (the femur). The MCL and LCL prevent excessive side-to-side motion and stabilize the knee during lateral movement.

In addition to these ligaments, each knee is equipped with two fibrocartilage menisci. Each meniscus is designed to prevent excessive movement of the knee and absorb the various stress placed on and through the joint. 

Despite their durability, each of these structures can fail if a considerable force or stress is applied to the knee. The manner in which the stress occurs can shape the tissues involved in the injury. The ACL is vulnerable in multiple positions but commonly occurs when the foot is planted and the athlete attempts to make a hard or sudden cut. ACL failure can also occur if the knee is hyperextended or violently torqued in a particular way.

Furthermore, the force needed to rupture the ACL will often damage other aspects of the knee. 

For example, if the knee is twisted and an outside load is placed through the joint, a trio of injuries known as the “Unhappy Triad” can occur.  In this type of injury, the ACL, MCL, and medial meniscus are all damaged.

And it is not just stabilizing structures that are vulnerable. ACL ruptures are often accompanied by bone damage. When the force needed to tear the ligament is applied, the distal end of the femur (the femoral condyle) collides with proximal end of one of the tibia (the tibial plateau). This impact can leave the surfaces of both bones contused in an occurrence known as “kissing contusions.”  In other cases, the bone can break.

Lamb’s fall left him with ligament (ACL), cartilage (lateral meniscus), and bone (femoral condyle) damage. Given the timing of the injury, his recovery will undoubtably carry over into the 2020-2021 season. Excluding the still recovering DeMarcus Cousins and Klay Thompson, the average return to play for recent ACL tears in the NBA is roughly 342 days. The complexity of Lamb’s injury could prolong that timeline, especially if additional surgical intervention is needed for any of his concurrent injuries.

Fortunately, Lamb will be working with an Indiana medical team that has established itself as one of the top units in the NBA. Led by Josh Corbeil and Shawn Windle, the group has finished the year as a top-five staff in seven of the past nine seasons and surrendered the sixth fewest number of games lost to injury or illness since the 2005-2006 season.