Disorders of the Knee Sports medicine

Chondromalacia Patella Abnormal softening of the cartilage under the kneecap Symptoms are generally a vague discomfort of the inner knee area aggravated by activity (running, jumping, climbing or descending stairs) or by prolonged sitting with knees in a moderately bent position Patients frequently have abnormal patellar tracking toward the lateral side of the femur

Treatment Primary goal for treatment and rehab is to create a straighter pathway for the patella to follow during contraction of quads Icing and anti-inflammatory medications Selective strengthening of the inner portion of the quadriceps

Patellar Dislocation Usually occurs as result of sudden direction changes while running and the knee is under stress May occur as result of direct injury

Osgood-Schlatter Disease One of the most common causes of knee pain in young athletes Swelling, pain and tenderness just below knee Occurs mostly in boys who are having growth spurt during their pre-teen or teenage years Only rarely persists beyond the growing stage

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

Patellar Tendinitis “Jumper’s Knee” Relatively common inflammatory condition that causes pain in the anterior aspect of knee Begins as inflammation of patellar tendon where it attaches to the patella Can progress to tearing or degeneration of the tendon

Treatment Rest the injured area until symptoms have subsided RICENSAIDS Strengthen the quadriceps Neoprene sleeves or braces

Osteochondritis Dissecans Blood supply to the area at the end of the bone is cut off A fragment may gradually loosen, separate and cause pain Knee is most commonly affected

Symptoms Pain “Locking” of the joint Feeling of the joint wanting to “give way” Decreased joint movement, limited ROM Limping Swelling and tenderness over the joint Stiffness after resting

Causes and Treatment Injury or stress Restricted blood supply Resting the joint Immobilization of the joint NSAIDS

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

ACL Tear Most often occurs when an athlete suddenly pivots causing excessive rotational forces on the ligament Sudden giving way of the knee May hear a 'pop' at the time of injury Sudden swelling of the knee joint Pain in the knee when walking