Morel Lavallee Lesion Hip & Knee Treatment, MRI, ICD-10

What is Morel Lavallee Lesion?

A Morel-Lavallée lesion (MLL) is a closed traumatic soft tissue degloving injury caused by the separation of the dermis from the underlying fascia, which generally occurs after blunt trauma or high-energy trauma such as car accidents, falls, or sports-related injuries. This damage is the consequence of shearing forces that disrupt the lymphatic and blood vessels, which ultimately leads to an accumulation of blood, lymph, and necrotic fat in a possible space, which can end in a hematoma or seroma.

Morel Lavallee Lesion Hip & Knee Treatment, MRI, ICD-10

Morel Lavallee Hip Lesion

A hip morel Lavallee lesion is a fluid accumulation that develops between the deep fascia and the muscles; it commonly occurs after a traumatic incident. The formation of a cystic cavity by the buildup of necrotic fat, blood, and lymph is a characteristic of this illness. Trauma, such as vehicle accidents or falls, is a prevalent cause of Hip Morel Lavallee Lesions.

Morel Lavallee Lesion Knee

MLLs in the knee can originate from shearing trauma during sports like football, with shearing blows on the playing surface being the most frequent mechanism of injury. In most situations, elite athletes can resume practice and games well before the lesion fully heals. However, in about half of those cases, aspiration is necessary for successful therapy because recurring fluid collections can occur.

Morel Lavallee Lesion Treatment

Open debridement, percutaneous aspiration, and nonoperative treatment are the available treatments for managing Morel-Lavallée lesions. There is no clear consensus on the optimal management strategy, and treatment is determined by the individual patient and the surgeon's discretion. Conservative management choices include the following:

Compression bandaging
Sclerosants, administered either in combination with other therapeutic interventions or in isolation
Percutaneous puncture aspiration

More invasive medical procedures consist of:

In chronic cases, open debridement with pseudo-capsule excision is performed.
Closure of dead space within the lesion, which can be accomplished in a variety of ways, including fibrin sealant, quilting sutures, and low suction drains.

Morel Lavallee Lesion MRI

The diagnostic imaging technique of choice for assessing Morel-Lavallée lesions is MRI. The lesions are usually crescentic, fusiform, or oval, which is consistent with fluid dissecting along fascial planes that have been damaged. MRI imaging of Morel-Lavallée lesions shows hemolymphatic fluid concentration, chronicity of blood by-products, fat (viable or necrotic), and capsule presence.