Injuries of the Knee

Dislocated Patella Def: When the patella “pops out” of its

normal tracking with the patella MOI: usually a blow to the side of the patella

-- some people are more prone to this injury due to biomechanics

Dislocated Patella S/Sx: obvious

deformity of the knee, loses all function and is usually locked in flexion

Tx: ice, send to doctor -- the patella may be reduced by applying slight pressure on the patella while gently straightening the knee

Osgood-Schlatters Def: inflammation at the point where the

patellar tendon attaches to the tibial tubercle MOI: most often seen in adolescent boys

who are experiencing a growth spurt

Osgood-Schlatters S/Sx: enlargement of

the tibial tubercle -- athlete will complain of severe pain when kneeling, jumping and running -- point tenderness over tibial tubercle

Tx: ice, NSAID’s and reduction of activity

Prepatellar Bursitis Def: inflammation of

the prepatellar bursae of the knee

MOI: the bursae may become irritated from continued kneeling or repetitive fall on the knee -- may also be caused from over-use of the patellar tendon

Prepatellar Bursitis S/Sx: obvious localized

swelling Tx: rest, NSAID’s and

ice -- when they are able to return to play, they should heat the area before play and ice after-- the knee should be protected from further trauma with padding

Torn Medial Collateral Ligament

Def: Sprain of the MCL MOI: Usually a direct blow to the lateral

side of the knee causing a valgus force

* More commonly injured than the LCL. Often seen with a torn medial menicus

S/Sx: joint effusion, point tenderness over the medial aspect of knee, positive valgus stress test

Tx: The MCL receives good blood supply and thus usually heals well on its own. Send to a doctor, RICE, brace.

Torn Lateral Collateral Ligament

Def: Sprain of the LCL MOI: usually a direct blow to the medial

side of the knee causing a varus force

S/Sx: history of varus force, point tender over lateral aspect of knee, positive varus stress test

Tx: Same as for MCL

Posterior Cruciate Ligament Tear Def: a sprain of the PCL MOI: most commonly a car accident or fall

directly on the flexed knee

Posterior Cruciate Ligament Tear S/Sx: Swelling, the

athlete will complain of hearing a “pop”, positive posterior sag sign (you may also have a positive anterior drawer sign)

Tx: immediate RICE, may need crutches, refer to a doctor

Note: the “sag” in the left leg

Posterior Drawer Sign

Anterior Cruciate Ligament Tear Def: a sprain of the

ACL MOI: usually a non-

contact injury resulting from a plant-and-cut or hyperextension mechanism --- more common in female soccer and basketball players

MOI: usually a non-contact injury resulting from a plant-and-cut or hyperextension mechanism --- more common in female soccer and basketball players

Anterior Cruciate Ligament Tear S/Sx: swelling, athlete

will complain of hearing or feeling a “pop” and having the knee “give out”, positive anterior drawer sign

Tx: RICE, NSAID’s may need crutches, refer to a doctor

Anterior Drawer Test

Torn Meniscus

Def: tear of the medial or lateral meniscus, the medial meniscus is more often injured than the lateral

MOI: Medial meniscus tears can result from a valgus force, both can be injured from rotational forces (plant and cut)

S/Sx: point tenderness along the joint line, pain, possible loss of motion, patient may complain of the knee “popping”, “locking” or “clicking”, may have pain or inability to squat. Positive Apley’s Compression/Distraction test or McMurray’s Test

Tx: Surgery. Symptomatic tears can eventually lead to serious articular degeneration