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Anterior Knee Pain in Athletes

Anterior Knee Pain in Athletes. Jerome F. Wall, MD, FACS. Anterior Knee Pain in Athletes. Most common Most disabling Difficult to make accurate diagnosis Long differential diagnosis. Anterior Knee Pain in Athletes. Response Related To: Correct diagnosis Appropriate treatment plan

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Anterior Knee Pain in Athletes

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  1. Anterior Knee Pain in Athletes Jerome F. Wall, MD, FACS

  2. Anterior Knee Pain in Athletes • Most common • Most disabling • Difficult to make accurate diagnosis • Long differential diagnosis

  3. Anterior Knee Pain in Athletes • Response Related To: • Correct diagnosis • Appropriate treatment plan • Appropriate rehabilitation program

  4. Clinical History • Gender: • Females 2X Males

  5. Clinical History • Age: Young • Stresses of growth

  6. Clinical History • Age:Middle • Overuse

  7. Clinical History • Age: Mature • Lack of conditioning

  8. Onset • Acute - Traumatic • Fracture • Dislocation

  9. Onset • Chronic - Overuse vs Metabolic

  10. Nature of Pain • Sharp • Synovial or meniscal • Impingement • Loose bodies

  11. Nature of Pain • Aching • Inflammatory

  12. Nature of Pain • After Activity • Patella • Plica

  13. Site of Pain • Joint Line • Femoral Condyle • Patella

  14. Activity Related • Positional

  15. Activity Related • Stairs

  16. Activity Related • Theatre Sign

  17. Anatomy • Physical Exam • Methodical • Precise • Reproducible

  18. Physical Exam • Comparison • Measurements • Bony & soft tissue land marks

  19. Developmental • Bipartite patella • Osgood-Schlatter

  20. Cystic Abnormalities • Meniscal cyst

  21. Cystic Abnormalities • Ganglion cyst • Synovial osteochondrmatosis

  22. Inflammatory Disorders • Bursitis • Pre-patellar • Tendinitis • Quadriceps • Patellar • Fat Pad Syndrome • Traumatic • Post surgery

  23. Patellar Femoral Incongruencies • Exam

  24. Patellar Femoral Incongruencies • X-Rays

  25. Patellar Femoral Incongruencies • Cine MRI

  26. Patellar Femoral Incongruencies • Arthroscopy

  27. Surgical Procedures • Lateral Retinacular Release

  28. Surgical Procedures • Proximal Realignment • VMO Plication

  29. Surgical Procedures • Distal Realignment • Maquet Procedure • Fulkerson Osteotomy

  30. Surgical Procedures • Patellectomy

  31. Anterior Knee Pain in Athletes Jerome F. Wall, MD, FACS

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