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Knee Injury in a Soccer Player Nell Kopp DO University of Kentucky Primary Care Sports Fellow.

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Presentation on theme: "Knee Injury in a Soccer Player Nell Kopp DO University of Kentucky Primary Care Sports Fellow."— Presentation transcript:

1 Knee Injury in a Soccer Player Nell Kopp DO University of Kentucky Primary Care Sports Fellow

2 15 yo female high school soccer player Presents to sports medicine clinic on crutches 2 day history of right knee pain

3 MOI: During a soccer game, she tripped over another player's feet going for the ball o suffered valgus injury to her right knee o Felt a pop with immediate pain over medial aspect Swelling developing within 24 hours Pain worsening since injury Worse w/ knee flexion and weightbearing Denies radiation of pain, numbness or tingling

4 Small effusion ROM o Flexion limited to 90 degrees o Full Extension TTP o MCL: more proximal o Lateral Femoral Condyle Negative Patellar Apprehension

5 Valgus/Varus Stress o No laxity at 0 Degrees o 30 degrees  Valgus: Guarding, Laxity (1+)  Varus: Stable Lachman: guarding without firm endpoint Negative Posterior Drawer

6 McMurray's: pain without catch/clunk o Localized deep in knee FROM at ankle Distal pulses 2+, Sensation Intact

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10 Plain Films: o 3 views right knee: no acute fracture

11 ACL injury Patellar Dislocation Bone Bruise Occult Fracture Meniscus Injury MCL sprain

12 MCL injury o Due to location of pain o Guarding/Laxity at 30 degree Valgus Stress Possible ACL injury o MOI o Guarding with Lachman

13 Treatment Plan o TROM locked in Extension o Crutches o MRI for further evaluation

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22 MRI: o Nondisplaced Salter-Harris IV fracture distal femur o Grade 2 sprain of the superficial medial collateral ligament and patellofemoral ligament at the femoral attachment o Bone marrow contusion pattern suggesting a pivot shift injury with intact ACL

23 MCL sprain with non displaced Salter IV femur fracture

24 Patient had routine follow up After MRI, 2wks, 5 wks and 10 wks post injury

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26 6 wks nonweightbearing in TROM Progressive return to weightbearing activities TROM: o Locked in Extension x 4 wks o Unlocked for 2 wks following

27 Physical Therapy o Initially: SLR, Quad Sets and ROM o 4 wks: Weightbearing activities o 6 wks: Transitioned to sport specific modalities and agility drills o 10 wks: Return to play

28 Returned to Soccer at 10 wks post injury 6 mos post injury denies any knee pain or instability symptoms


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