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A Clear Giveaway: Curious Case Of The Unstable Knee - Page #1
 

Author: Patrick Murray, MD
Co Author #1: Wood, Scott, ATC
Co Author #2: Alstair, Bryair, ATC
Co Author #3: Coris, Eric MD, FACSM
Senior Editor: Drew Duerson, MD
Editor: Suraj Achar, MD

Patient Presentation:
A 23-year-old Division I collegiate football offensive lineman presented after sustaining an acute traumatic injury to his right knee during training camp.

History:
The patient reported that during a one-on-one drill with defensive player, he was twisted while his foot remained planted on the ground. Athletic training staff witnessed forced knee flexion with rotational and valgus stress applied to the knee. He felt an immediate "pop" at the time of injury. He subsequently developed immediate swelling and deep anterior knee pain. He was able to ambulate but reported pain and sensation of instability. Additional symptoms included stiffness and weakness. He denied any prior knee injuries or surgeries. His symptoms had mildly improved with ice, immobilization, and nonsteroidal anti-inflammatory medications. He was using crutches for ambulation at presentation.

Physical Exam:
Right knee: No obvious deformity, mild genu valgum, slight lateral patellar tracking. Tenderness at medial joint line, medial patellar facet, patellar tendon. 1+ effusion. Negative patellar grind. Negative patellar trapping. Limited active range of motion due to pain and apprehension. Passive range of motion pain with flexion beyond 60 degrees. 4 out of 5 flexion and extension strength. Guarded but positive 1+ anterior drawer, negative Lachman, negative posterior drawer, negative varus and valgus stress tests. Positive medial joint line pain with Thessaly and McMurray's. Neurovascularly intact. No evidence of lymphatic disease.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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