Disorders of the KneeDisorders of the Knee

Sports medicineSports medicine

Chondromalacia PatellaChondromalacia Patella

Abnormal softening of the cartilage under the Abnormal softening of the cartilage under the kneecapkneecap

Symptoms are generally a vague discomfort of Symptoms are generally a vague discomfort of the inner knee area aggravated by activity the inner knee area aggravated by activity (running, jumping, climbing or descending stairs) (running, jumping, climbing or descending stairs) or by prolonged sitting with knees in a or by prolonged sitting with knees in a moderately bent positionmoderately bent position

Patients frequently have abnormal patellar Patients frequently have abnormal patellar tracking toward the lateral side of the femur tracking toward the lateral side of the femur

TreatmentTreatment

Primary goal for treatment and rehab is to Primary goal for treatment and rehab is to create a straighter pathway for the patella create a straighter pathway for the patella to follow during contraction of quadsto follow during contraction of quads

Icing and anti-inflammatory medicationsIcing and anti-inflammatory medications

Selective strengthening of the inner Selective strengthening of the inner portion of the quadriceps portion of the quadriceps

Patellar DislocationPatellar Dislocation

Usually occurs as result of sudden Usually occurs as result of sudden direction changes while running and the direction changes while running and the knee is under stressknee is under stress

May occur as result of direct injuryMay occur as result of direct injury

Osgood-Schlatter DiseaseOsgood-Schlatter Disease

One of the most common causes of knee One of the most common causes of knee pain in young athletespain in young athletesSwelling, pain and tenderness just below Swelling, pain and tenderness just below kneekneeOccurs mostly in boys who are having Occurs mostly in boys who are having growth spurt during their pre-teen or growth spurt during their pre-teen or teenage yearsteenage yearsOnly rarely persists beyond the growing Only rarely persists beyond the growing stagestage

TreatmentTreatment

Cut down on time spent playing sports Cut down on time spent playing sports until the pain has been gone for 2-4 until the pain has been gone for 2-4 monthsmonths

RICERICE

Patellar TendinitisPatellar Tendinitis

““Jumper’s Knee”Jumper’s Knee”

Relatively common inflammatory condition Relatively common inflammatory condition that causes pain in the anterior aspect of that causes pain in the anterior aspect of kneeknee

Begins as inflammation of patellar tendon Begins as inflammation of patellar tendon where it attaches to the patellawhere it attaches to the patella

Can progress to tearing or degeneration of Can progress to tearing or degeneration of the tendonthe tendon

TreatmentTreatment

Rest the injured area until symptoms have Rest the injured area until symptoms have subsidedsubsided

RICERICE

NSAIDSNSAIDS

Strengthen the quadricepsStrengthen the quadriceps

Neoprene sleeves or bracesNeoprene sleeves or braces

Osteochondritis DissecansOsteochondritis Dissecans

Blood supply to the area at the end of the Blood supply to the area at the end of the bone is cut offbone is cut off

A fragment may gradually loosen, A fragment may gradually loosen, separate and cause painseparate and cause pain

Knee is most commonly affectedKnee is most commonly affected

SymptomsSymptoms

PainPain

““Locking” of the jointLocking” of the joint

Feeling of the joint wanting to “give way”Feeling of the joint wanting to “give way”

Decreased joint movement, limited ROMDecreased joint movement, limited ROM

LimpingLimping

Swelling and tenderness over the jointSwelling and tenderness over the joint

Stiffness after restingStiffness after resting

Causes and TreatmentCauses and Treatment

Injury or stressInjury or stress

Restricted blood supplyRestricted blood supply

Resting the jointResting the joint

Immobilization of the jointImmobilization of the joint

NSAIDSNSAIDS

Meniscal InjuriesMeniscal Injuries

The two most common causes are The two most common causes are traumatic injury and degenerative traumatic injury and degenerative processesprocessesMost common mechanism of traumatic Most common mechanism of traumatic tear is when the knee is bent and then tear is when the knee is bent and then twistedtwistedNot uncommon for the meniscus to tear Not uncommon for the meniscus to tear along with injuries to the MCL and ACL along with injuries to the MCL and ACL (The unhappy triad)(The unhappy triad)

ACL TearACL Tear

Most often occurs when an athlete Most often occurs when an athlete suddenly pivots causing excessive suddenly pivots causing excessive rotational forces on the ligament rotational forces on the ligament

Sudden giving way of the knee Sudden giving way of the knee

May hear a 'pop' at the time of injury May hear a 'pop' at the time of injury

Sudden swelling of the knee joint Sudden swelling of the knee joint

Pain in the knee when walking Pain in the knee when walking