1. Knee Injuries
Sports Medicine 2

2. Knee Structures Hinge Joint Stability comes from ligamentous support
Femur, tibia, fibula, patella
Menisci
~ 2 oval fibrocartilages

4. Ligaments
ACL
~ Prevents the tibia from moving anteriorly or the femur from moving posteriorly
PCL
~ Prevents posterior movement of the tibia on the femur, hyperextension
MCL
~ Prevents valgus motion
LCL
~ Prevents varus force

6. ACL Tears
Cause: Direct lateral or valgus blow with the knee flexed and tibia externally rotated, lower leg rotated with the foot planted, or flexion deceleration injury
S/S: Hears/feels a ‘pop’ in the knee followed by immediate disability. Laxity of joint.
TX: RICE
Surgery
Rehabilitation
ST: Anterior Drawer test, Lachman test

7. Normal ACL
Torn ACL
Restructured ACL

8. MCL Tears
Cause: Result of a medially directed valgus force from lateral side or from external rotation of the tibia
S/S: Swelling, point tenderness, laxity on the medial side
TX: RICE
Crutches if unable to walk
Bracing
Surgery worse case
ST: Valgus Stress Test, anterior drawer test

11. LCL Tears
Cause: Result of a laterally directed varus force from the medial side or from internal rotation of the tibia.
“Rarely ever will you have an isolated LCL tear”
S/S: Pain and tenderness over the ligament, swelling, effusion, joint laxity
TX: RICE
Crutches if unable to walk
Surgery if bad enough
Brace
ST: Varus Stress Test

12. PCL Tears
Cause: A full weight bearing fall on a hyper flexed knee. Dashboard injury
S/S: Feels a ‘pop’ in the back of the knee. Tenderness and little swelling in popliteal fossa. Laxity may be noted.
TX: RICE
Quadricep strengthening on non-operative knees
Surgery in highly active
Brace
ST: Posterior Drawer test

13. Meniscal Tear
Cause: A weight bearing combined with a rotational force while extending of flexing the knee. Medial more common than lateral.
Acute vs. Chronic
S/S: Effusion on joint line, loss of motion, joint locking, and pain when squatting.
TX: RICE
quad sets
Surgery possible
ST: McMurray’s, Apley’s compression test

15. Meniscal Blood Supply

16. Patellar Tendonitis Cause: Jumping, kicking, or running.
S/S: Vague pain indicated, tenderness around bottom of patella, Point tenderness over tibial tuberosity
TX: RICE (ice cups)
NSAIDS
Cho-pat strap
Rehabilitation
ST: Strength test, ROM test

17. Osgood-Schlatter’s Disease
Cause: common in immature athletes. Repeated pull of the patellar tendon at the tibial tubercle.
S/S: Swelling, hemorrhage, and gradual degeneration of tubercle (causing deformity)
TX: Conservative: RICE (ice cups)
Out for 6 months to 1 year
Rehabilitation
ST: X-Ray

19. Larsen-Johansson Disease
Same as Osgood-Schlatter Disease but occurs at inferior pole of patella

21. Patellar Tendon Rupture
Cause: Sudden powerful contraction of quads with weight of the body applied to affected leg
***Steroid injections to this area increase likelihood of rupture
S/S: Patella moves upward, noticeable defect, and athlete cannot extend knee
TX: Conservative: Surgical repair
NSAIDS
ST: X-Ray, MRI

23. Chondromalacia Patella
Cause: wearing away of articular cartilage on the posterior aspect of patella
S/S: Pain while walking or deep bending
Going up stairs
Crepitation
TX: RICE
Avoid painful activities
Rhb
NSAIDS
Surgery
ST: History, Clarks sign, Patella grind test