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