Patellofemoral Injuries Taelar Shelton, MS, ATC, LAT, CES

Patellar Fracture MOI: direct or indirect trauma, severe pull of the patellar tendon when the knee is semi- flexed or a fall on the knee MOI: direct or indirect trauma, severe pull of the patellar tendon when the knee is semi- flexed or a fall on the knee S&S: hemorrhage, joint effusion, swelling, capsular tearing, separation of bone fragmnets S&S: hemorrhage, joint effusion, swelling, capsular tearing, separation of bone fragmnets Rx: x-ray conformation, ice with compression, splint and crutches for walking, referral to doctor, usually immobilized for 2-3 months Rx: x-ray conformation, ice with compression, splint and crutches for walking, referral to doctor, usually immobilized for 2-3 months

Subluxation/Dislocation of the Patella MOI- plant and twist MOI- plant and twist S&S, obvious deformity, usually lateral dislocation, VMO weakness, decrease in function, swelling, P! and decreased ROM S&S, obvious deformity, usually lateral dislocation, VMO weakness, decrease in function, swelling, P! and decreased ROM Rx- reduction by a physician, immobilize, crutches, RICE, work on quad strengthening, patellar tracking Rx- reduction by a physician, immobilize, crutches, RICE, work on quad strengthening, patellar tracking

Chondromalacia MOI- abnormal patellar tracking, tibial rotation, pronated foot, anteverted hip, genuvalgum, gradual degeneration MOI- abnormal patellar tracking, tibial rotation, pronated foot, anteverted hip, genuvalgum, gradual degeneration S&S- gradual degeneration of cartilage, p! with activities, swelling S&S- gradual degeneration of cartilage, p! with activities, swelling Rx- take care of the mechanism, rest prn, surgical intervention Rx- take care of the mechanism, rest prn, surgical intervention

Osgood-Schlatter Disease MOI- excessive strain of the patellar tendon MOI- excessive strain of the patellar tendon S&S- enlarged tibial tuberosity S&S- enlarged tibial tuberosity Rx- rest, ice after activities, strengthen quads and hamstrings Rx- rest, ice after activities, strengthen quads and hamstrings

Larsen-Johansson Disease MOI- at inferior pole of the patella, repetitive strain of the patellar tendon MOI- at inferior pole of the patella, repetitive strain of the patellar tendon S&S- swelling, P! and x-ray S&S- swelling, P! and x-ray Rx- ice, rest, wait to stress the knee until the growth plates are closed, isometrics Rx- ice, rest, wait to stress the knee until the growth plates are closed, isometrics

Patellar Tendonitis MOI- jumping or kicking that is repeated frequently that leads to degeneration MOI- jumping or kicking that is repeated frequently that leads to degeneration S&S- P! after activity progresses to during and after then gets worse after activity S&S- P! after activity progresses to during and after then gets worse after activity Rx- avoid the mechanism, use heating modalities prior to activity, ice after, transverse friction massage, rest prn Rx- avoid the mechanism, use heating modalities prior to activity, ice after, transverse friction massage, rest prn

Patellar Tendon Rupture MOI- sudden powerful quad contraction, usually previous Hx MOI- sudden powerful quad contraction, usually previous Hx S&S- obvious deformity, swelling, P! and patella alta S&S- obvious deformity, swelling, P! and patella alta Rx- surgical repair Rx- surgical repair

IT Band Friction Syndrome MOI- repetitive running or biking, usually have malalignment problems MOI- repetitive running or biking, usually have malalignment problems S&S- p! on distal insertion, +Ober’s test S&S- p! on distal insertion, +Ober’s test Rx- PRT, fix the malalignment, take the mechanism away Rx- PRT, fix the malalignment, take the mechanism away

Collapsing Knee MOI- week quads, chronic instability of the MCL, ACL or posterior capsule; torn meniscus; loose bodies; subluxating patella MOI- week quads, chronic instability of the MCL, ACL or posterior capsule; torn meniscus; loose bodies; subluxating patella S&S- knee feels like it will collapse or give way S&S- knee feels like it will collapse or give way Rx- quad strengthening, fix the mechanism of injury Rx- quad strengthening, fix the mechanism of injury