Injuries of the Knee and Hip

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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
Note: the “sag” in the left leg
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
Posterior Drawer Sign
Anterior Cruciate Ligament Tear
Def: a sprain of the
ACL
MOI: usually a noncontact 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
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