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Knee Injuries Taelar Shelton, MS, ATC, LAT, CES Terminology Sprains (ligaments) 1ST degree 2nd degree 3rd degree MOI- mechanism of injury S&S- signs and symptoms Rx- treatment and management P! means pain Patellofemoral vs tibiofemoral Contusion Bruise MOI- Blow to the bony tissue or muscles crossing the knee S&S- Pain, acute inflammation, swelling, discoloration Rx- Rest, usually RTP in 24-48 hours, RICE Bursitis MOI- Acute, chronic or recurrent Inflammation due to: continued kneeling or overuse of patellar tendon S&S- swelling Rx- Eliminate cause, decrease inflammation Aspirate if chronic MCL sprain (1st, 2nd, 3rd deg) MOI- valgus force S&S- tender on jt line, p! during lateral movement, swelling, decrease in stability, +valgus stress test Rx- RICE, work on ROM, strength, crutches if they walk with a limp, brace, cryokinetics, grade 3 should be referred, not usually surgical LCL sprain (Acute lateral knee sprain) MOI- varus force; outward force to lateral capsule and LCL, leg internally rotated knee is forced outward S&S- P! on lateral jt, some swelling, jt instability, +varus stress test Rx- similar to MCL sprain ACL sprain MOI- plant and twist, forced hyperextension S&S- pop, p!, swelling, difficulty walking, +anterior drawer and lachman’s Rx- test quickly, refer for MRI, RICE, surgery, brace, crutches, rehab for 6-12 months PCL sprain MOI- fall on flexed knee, dashboard injury, hard blow to the anterior aspect of knee, rotational force S&S- pop, tenderness on posterior knee, some swelling, + sag sign, + posterior drawer Rx- RICE, quad strengthening, referral- occasionally surgery (6 week rehab) Meniscal Lesions MOI- valgus force with an MCL sprain, weight bearing activity with a rotation of the tibia S&S- catching, locking, jt p!, effusion, muscle spasm, p! with squats, MRI, +McMurry, +Appley’s Rx- referral to a physician, MRI, surgery may be necessary (menisectomy or mensical repair), rehab Knee Plica MOI- synovial membrane folds, born with it and it wasn’t absorbed, can become pathological ~20% of population S&S- catching, P! usually on medial aspect of the jt, +plica stutter test Rx- conservatively or surgical intervention Knee Fat Pad MOI- fat pad gets wedged, hyperextension, kneeling, direct blow S&S- hemorrhaging, p!, weakness, swelling, stiffness Rx- rest, heel elevation, ice Loose Body “Joint Mice” MOI- Repeated trauma to knee, fragments of menisci or synovial tissue that move around the joint space and become lodged S&S- locking, popping, knee giving way Rx- surgical removal