Common Injuries in the Knee

  • Q-Angle
      * Angle measured from the anterior superior iliac spine to the patella and from     the patella to the tibial tuberosity
  • Patellar Dislocation
      * MOI: Likely to happen during high speed motions especially cutting and pivoting
      * Almost always shifts laterally
        *
      * S&S
        * Moderate to extreme pain
        * Moderate swelling
        * Complete loss of ROM
        * Obvious deformity
      * Treatment: Reduction, xray, brace, RTP
  • Patella-Femoral Stress Syndrome (PFSS)
      * Chronic pain found in the patellar region that can be blamed on tracking issues or overuse
        *
      * MOI: Chronic, improper lateral tracking of patella
      * S&S
        * Pain and tenderness in lateral aspect of the patella
        * Slight swelling
        * Crepitus or popping with extension
      * Treatment
        * Rehab: strengthening and stretching protocol to help muscular issues (knees and hips)
        * Tape or bracing
  • Chondromalacia
      * Roughening of the protective cartilage found on the underside of the patella
      * MOI: abnormal patellar tracking or trauma from an acute injury
      * S&S
        * Pain underneath the patella
        * Grinding or popping during motion
        * Slight chronic swelling
      * Treatment: ice therapy, quad strengthening, Anti-inflammatory medication, brace or knee sleeve, surgical intervention if necessary
  • Osgood-Schlatter’s Disease
      * MOI: Chronic condition found in adolescents, typically after a dramatic growth spurt
      * Adolescents and puberty the tendons are stronger than the bones. This discrepancy causes bone damage as the tendon microscopically pulls away from its attachment.
        * Increased repair that over time develops into an enlarged tuberosity
          *
      * S&S
        * Pain at insertion of the patella tendon
        * Tenderness to palpation
        * Enlarged tibial tuberosity
        * Pain with jumping and running
      * Treatment
        * RICE, Anti-inflammatories, ultrasound, knee strap, surgical intervention
  • Patella Tendon Rupture
      * Rare in younger athletes more common in older professional or recreational athletes
      * MOI: strong contraction of the quad muscles during jumping or running
      * S&S
        * Extreme pain followed by a dramatic decrease in pain levels
        * Significant swelling
        * Shifting of the patella out of its normal position into the mid thigh area
        * Complete loss of knee extension
        * Previous history of tendonitis or inflammation
      * Treatment: Surgical repair, recovery 1 year
  • Meniscus Tears
      * Very common in athletics
      * MOI: twisting motion in conjunction with valgus stress (cutting movements as the athlete attempts to shift and push off the involved leg
        *
      * S&S
        * Pain, especially when moved similarly to the MOI
        * Pain with full extension and flexion
        * Effusion (swelling in the joint)
        * Pain along the line of the joint between the femur and tibia
        * Sensation of locking or giving out
        * Clicking or popping sound with movement
      * Treatment
        * Depends on location and type of damage that meniscus has incurred
        * Surgical intervention
          * Repaired through reattachment and sutures (outer)
          * Cleaned up by removing the injured tissue (inner)
      * Types
        *
  • Anterior Cruciate Ligament (ACL) Tear
      * ACL prevents anterior translation or shifting of the tibia in relation to the femur
      * MOI: most commonly noncontact shifting of the knee, often seen with deceleration
        *
      * S&S
        * Pain in joint
        * Athlete complains of pop at time of injury
        * Sense of feeling “loose” in joint, giving away or shifting
        * Swelling that increases rapidly post-injury
      * Treatment
        * RICE
          * Grade I & II sprain -> rehab
          * Complete tear requires surgery
            * RTP 4-6 months (closer to 1 year)
            * Prehab very important
  • Posterior Cruciate Ligament (PCL) Sprains/Tears
      * Posterior Cruciate Ligament prevents posterior translation of the tibia in relation to the femur
      * PCL is the strongest ligament in the knee which makes injury less often than in the ACL
      * MOI: direct blow to the proximal tibia and knee while flexed at 90 degrees (ligament is at a vulnerable position)
        *
      * S&S
        * Pain and tenderness on posterior aspect of knee
        * Slight swelling in popliteal region
        * Joint laxity
        * Loose feeling when walking
      * Treatment
        * RICE, Rehab strengthening hamstring and quads, surgery, bracing
  • Medial Collateral Ligament (MCL) Sprains/Tears
      * Very commonly injured in athletics due to the frequency of contact to the outer side of the knee forcing it medially
        *
      * S&S
        * Pain increasing with severity
        * Joint stiffness
        * Slight to moderate swelling over ligament
        * Decreased ROM
        * Joint laxity medially
      * Treatment: RICE, isolated tear?, rehabilitation (abductors, adductors)
  • Lateral Collateral Ligament (LCL) Sprains/Tears
      * Lateral Collateral Ligament- injured much less than the MCL and less prevalent in athletics
      * MOI: varus stress to inferior of the knee
        *
      * S&S
        * Pain over lateral aspect of the knee
        * Slight to moderate swelling over lateral aspect
        * Joint laxity laterally
        * Joint stiffness
        * Decreased ROM
      * Treatment: RICE, progressive rehab, RTP, surgery is unlikely if just isolated LCL tear