1. Knee pain
Zahra badorestani

2. History Rt. Knee anterior pain No significant trauma
Recurrent episodes of falling
Recurrent effusion
Unable to extend knee actively

3. See movie

4. Exam
No coronal & sagital deformity
Mild swelling & effusion

5. Thigh-foot angle 50 ext. rot.

6. Exam Full passive ROM Stable knee Patella grind (+)
Severe patella in-facing
Patella apprehension (–)
Severe lat. Facet tenderness
Q angle 30 degree

7. Exam
Hips rotation in extension
- internal 80
- external 20

9. Trochlear dysplasia type A

10. Knee CT scan
Lateral patellar tilt angle

11. Ante-version Rt. 39 degree Lt. 11degree

12. Tibia rotation CT scan

13. Tibial external rotation 46 degree

14. CT Scan TT-TG 22 mm

15. Diagnosis ? Miserable mal-rotation syndrome
Probable (objective)patella dislocation

16. Plan ?

19. Perpendicular to mechanical tibia axis

25. See movie

26. Thank you for attention