Two For One: A Volleyball Associated Injury - Page #1

Author: Stefan Iacob, MD
Co Author #1: Dr. Jason A. Smith, DO, FAOASM
Senior Editor: Marc Hilgers, MD, PhD, FAMSSM
Editor: Blake Corcoran, MD, CAQSM

Patient Presentation:
A 25-year-old male with a history of patellar tendinitis of the right knee and surgically repaired lumbar disc herniation presented to the Orthopedic Sports Medicine office for consultation regarding left knee pain for approximately 2 weeks.

The patient had presented to the Emergency Department two weeks prior for an injury occurring during volleyball where he had jumped and landed predominantly on his left leg causing it to buckle. He had immediate discomfort in the joint which persisted as a dull throbbing pain. There was no painful popping or clicking. Additionally, the patient's knee did not catch or lock and it had not been giving out. He had noted pain with ambulation, using stairs, sitting for a prolonged period of time, and rising up from sitting. The patient had been using a straight leg immobilizer and crutches to assist with ambulation and taking ibuprofen as needed for his pain.

Physical Exam:
Inspection: Soft tissues were noted to have mild swelling. The patient's gait was antalgic.
Palpation: Joint line was tender laterally. There was facet pain to palpation of the patella.
Patient's Neurovascular exam was within normal limits, including the Motor, Sensory and Pulse examination. Patellar Reflex was 2+.
Range of Motion (ROM): Knee Flexion to 90 degrees, Extension to 5 degrees.
Special tests: Lachman's Positive Grade 2+, Anterior Drawer test positive for laxity with anterior translocation. Negative McMurray test. Patient did not tolerate the Pivot-Shift test. No other signs of ligament laxity were present during this physical examination.

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