Complex knee injuries from bouldering: A case series

IF 3.3 Q1 ORTHOPEDICS

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2025-08-22 DOI:10.1016/j.jisako.2025.100995

Jhulia Kawachi Cruz, Khim Yew Chew, Mok Ying Ren, Yee Han Dave Lee

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Abstract

Introduction/objectives

Bouldering, a dynamic climbing discipline performed without ropes, is associated with high-energy ground falls. While most existing climbing injury literature has focused on the upper extremities, our data indicated an increasing number of complex knee injuries related to bouldering. This review was conducted to characterize the injury patterns sustained from ground falls during bouldering, and to compare the relative burden of these injuries with those sustained in other high-participation sports.

Methods

A retrospective case series was performed, including climbers who presented with knee injuries from ground falls during bouldering between March 2022 and October 2024. Patient demographics, injury mechanisms, ligamentous and meniscal pathology, as well as osseous or chondral damage were collected. The injuries were stratified by sex, age group, and injury complexity, including multiligament injury, meniscus tears, and osseous or chondral involvement. The bouldering-related injuries were then compared to institutional data from soccer and basketball, the two most common causes of sports-related knee injuries requiring surgery at the institution’s sports center.

Results

Nineteen patients were included, with a mean age of 27 ± 5.1 years. Of these, 15 (78.9 %) sustained combined anterior cruciate ligament and meniscus injuries. Surgical intervention was performed in 18 (94.7 %) patients. Multiligament knee injuries occurred in 4 (21.2 %) bouldering cases, accounting for 20 % of all multiligament knee injuries treated during the study period. Meniscus root tears were identified in 4 (21.1 %) bouldering cases, representing 22 % of all surgically treated meniscus root tears. Bone contusions consistent with pivot-shift patterns were observed in 52.6 % of patients, with cartilage fissuring and sulcus terminalis impaction in 10.5 % each. Compared to soccer and basketball, bouldering demonstrated a relatively higher proportion of complex knee injuries, despite lower participation volumes.

Conclusion

Ground falls during bouldering ground falls have been associated with a high proportion of complex knee injuries, including multiligament knee injuries, meniscus root tears, and injuries to both menisci. These injury patterns are believed to result from high-energy axial and rotational loading, and suggest the need for increased awareness, preventive strategies, and rehabilitation programs tailored to the sport.

Level of evidence

Level 4, Case series.

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抱石引起的复杂膝关节损伤：一个病例系列。

介绍/目标：抱石是一种动态攀岩训练，没有绳索，与高能地面坠落有关。虽然大多数现有的攀岩损伤文献都集中在上肢，但我们的数据表明，与抱石有关的复杂膝关节损伤越来越多。这篇综述是为了描述抱石地面坠落造成的损伤模式，并将这些损伤的相对负担与其他高参与运动中造成的损伤进行比较。方法：采用回顾性病例系列，包括2022年3月至2024年10月期间因抱石地面坠落而出现膝盖损伤的登山者。收集患者的人口统计资料、损伤机制、韧带和半月板病理以及骨或软骨损伤。损伤按性别、年龄组和损伤复杂性分层，包括多韧带损伤、半月板撕裂、骨或软骨受累。然后将抱石相关的损伤与足球和篮球的机构数据进行比较，这两种最常见的运动相关膝盖损伤原因需要在该机构的体育中心进行手术。结果：19例患者入组，平均年龄27±5.1岁。其中15例（78.9%）持续前交叉韧带（ACL）和半月板合并损伤。手术干预18例（94.7%）。4例（21.2%）抱石患者出现多韧带损伤，占研究期间所有MLKI治疗病例的20%。4例（21.1%）抱石病例发现半月板根撕裂，占手术治疗半月板根撕裂的22%。52.6%的患者出现骨性挫伤，软骨裂和终末沟嵌塞各占10.5%。与足球和篮球相比，抱石运动显示出相对较高的复杂膝盖损伤比例，尽管参与人数较少。结论：抱石地面坠落与膝关节多韧带损伤、半月板根撕裂、双半月板损伤等复杂损伤的发生率较高。这些损伤模式被认为是由高能量的轴向和旋转载荷造成的，这表明需要提高意识，预防策略和针对运动的康复计划。证据级别：4级，案例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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