Learning Objectives. Meniscal Injuries of the Knee. Meniscal Anatomy. Medial Meniscus. Chock Block Shape. Lateral Meniscus

Size: px
Start display at page:

Download "Learning Objectives. Meniscal Injuries of the Knee. Meniscal Anatomy. Medial Meniscus. Chock Block Shape. Lateral Meniscus"

Transcription

1 Meniscal Injuries of the Knee Learning Objectives Edward P. Mulligan, MS, PT, SCS, ATC VP, National Director of Clinical Education HealthSouth Corporation Grapevine, TX Clinical Instructor University of Texas Southwestern PT Dept Dallas, TX The contents of this presentation are copyrighted 2004 by. They may not be utilied, reproduced, stored, or transmitted in any form or by any means, electronic or mechanical, or by any information storage or retrieval system, without permission in writing from Edward P. Mulligan. Following the completion of the inservice the participant will be able to: 1. identify meniscal anatomy and vascular penetration 2. describe meniscal biomechanics, pathomechanics, and mechanisms of injury 3. explain common meniscal mechanisms and resultant classification of injury 4. describe relevant orthopedic examination procedures relevant to the meniscus 5. define indications for surgical excision, repair, and allograft replacement 6. design and effective post-operative rehab program Meniscal Anatomy Semilunar wedges of fibrocartilage interposed between the femoral condyles and tibial plateau Medial Meniscus "C" shaped Broader posteriorly than anteriorly Peripheral Attachments: entire peripheral border is firmly attached to the medial capsule semimembranosus tendon slip attaches to posterior horn fibers of ACL attach to anterior horn meniscopatellar fibers attach to medial border of meniscus ED Lateral Meniscus Chock Block Shape "O" shaped covering 2/3 of tibial plateau Smaller in diameter, thicker in periphery, and wider in body than the medial meniscus More mobile than medial meniscus Peripheral Attachments: popliteus muscle (not tendon) sends fibrous slip to posterior border ligament of Wrisberg (meniscofemoral ligament) attaches to posterior horn anterior horn to ACL Frontal and sagittal x-sections show the triangular wedge shape (thick on periphery and thin centrally)

2 Meniscal Vascularity Meniscal Vascularity Blood supply comes from the genicular arteries with vascular penetration to the peripheral 10-30% Vascular Zones Red Zone - peripheral capsular attachment area; outer 3 mm rim Pink Zone -junction of vascular and avascular one; blood supply on periphery, but not centrally Avascular Zone - inner 2/3 of meniscus without blood supply Meniscal Function Meniscal Function Joint Stability Small but significant role in resisting varus, valgus, rotational, and AP stresses If ACL intact, menisectomy does not significantly increase AP laxity If ACL deficient, menisci play a more important role in stability After menisectomy there is a significant increase (3 mm) in AP laxity Removal of posterior horn of medial meniscus alone will destabilie the meniscus Shock Absorption and Load Transmission Menisci the tibiofemoral contact area by 75% Loss of menisci results in smaller areas of tibiofemoral contact Partial menisectomies peak local contact stress by 65%; total menisectomy by 235% Menisci transfer centrally applied stresses radially Loss of menisci function through menisectomy or radial tear will result in increased load transfer to articular cartilage and subchondral bone Meniscal Function Meniscal Passive Biomechanics Nutrition and Joint Lubrication The menisci help distribute a thin film of synovial fluid over the surface of the articular cartilage Femoral condyles displace menisci as a result of compression and translation the conjoint internal rotation of the tibia during flexion occurs about an axis medial to the knee joint menisci move posterior with flexion and anterior with extension medial meniscus moves about 6 mm and the lateral meniscus about 12 mm Joint Congruency Tapered ring geometry promotes the mating of two incongruent surfaces

3 Part 2: Meniscal Active Biomechanics Flexion Mechanisms, Classification, and Examination Extension Medial Meniscus - posterior glide is assisted by semimembranosus and counteracted by the pull of the meniscopatellar fibers and the ACL which attach to the anterior horn Lateral Meniscus - posterior glide is assisted by the fibers of the popliteus Medial Meniscus -assisted by meniscopatellar fibers and influenced by the active contraction of the quads Lateral Meniscus - posterior horn is pulled anteriorly by the increased tension on the meniscofemoral ligaments from the PCL Tibial Rotation SMB POP influenced by meniscopatellar fiber tension and the larger articulating femoral condyle Meniscal Tears: Mechanism of Injury Meniscal Tears: Mechanism of Injury Elderly Degeneration Youthful Trauma Rotational and Compressive forces with the knee partially flexed Non-specific trauma with slow, insidious onset 60% likelihood of degenerative tear after 60 menisci degenerate as they become less pliable and complex or radial tearing is generally irreparable menisci are torn (usually longitudinal tears) when they are caught, pinched, or impaled between the condyles Meniscal Injury Predisposing Factors Abnormal mechanical axes discoid lateral meniscus Congenital anomalies genu varus/valgus Discoid menisci Degenerative menisci Ligamentous laxity Meniscal Injury Incidence Medial meniscus is torn 5-7 times more often than lateral meniscus Medial meniscus is injured more often because it is far less mobile The least mobile portion of the menisci is the medial posterior horn Posterior horn tears most common medially and transverse tears most common laterally The medial meniscus is most commonly injured in the stable knee or in the chronic ACL deficient knee The lateral meniscus is most commonly injured with an acute ACL tear. 3

4 Meniscal Injury Classifications Shape Complete vs. Incomplete Stable vs. Unstable Peripheral vs. Central Red - blood supply on both sides Good potential to heal Pink - blood supply on periphery, but not centrally - within the avascular one Poor potential to heal Meniscal Injury Clinical Features subjective factors to differentiate meniscal and patellar pathology History Trauma - twisting injury Degenerative - no history of specific injury; often in middle age Mechanical Symptoms locking, catching, clicking, snapping, giving way Swelling and Pain Physical Exam 1. Joint line tenderness 2. Effusion 3. + McMurray's, Apley's, Squat Test 4. Quad Shutdown or atrophy MENISCAL Twisting, traumatic onset Joint line symptoms Locking Sharp pain with loaded cutting maneuvers PATELLOFEMORAL Gradual, insidious onset Diffuse, anterior symptoms Grating, Aching, Crepitation Pain coming into or out of squat Objective Exam: Special Tests Meniscal Entrapment Testing Specific combinations of motion to identify symptomatic meniscal injury Flexion to extension with tibia: externally rotated and valgus stress internally rotated and valgus stress externally rotated and varus stress internally rotated and varus stress As you move through the range of motion, note where and when the patient notes pain or catching-clicking sensations.

5 meniscal entrapment test Rationale Flexion compresses the posterior portion of the menisci. Catching or locking in flexed positions indicates damage to the posterior meniscal elements. Extension compresses the anterior portion of the menisci. Catching or locking in extended positions indicates damage to the anterior meniscal elements. Tibial Rotation used to distort the menisci & assist in identifying the area of the meniscal lesion meniscal entrapment test Rationale Varus Stress compresses the medial compartment to increase catching, clicking, or locking symptoms may cause stretch pain of meniscal attachments on the lateral side of the joint Valgus Stress compresses the lateral compartment to increase catching, clicking, or locking symptoms may cause stretch pain of meniscal attachments on medial side of the joint meniscal entrapment test Interpretation what portion of the menisci is under stress? Meniscal tears/lesions do not hurt (they are aneural) - they click, catch, or lock The pain produced from the entrapment tests occurs at the site of meniscal tissue attachments. Pain is located over the specific area of pathology with palpation but may be reported in the opposite corner of the actual pathology during the entrapment tests with these specific entrapment test methods posteromedial posterolateral McMurray Test Medial Meniscal Testing Extension from a hyperflexed position in varus and internal rotation = posteromedial meniscal injury McMurray Test Lateral Meniscal Testing Extension from a hyperflexed position in valgus - external rotation = posterolateral meniscal injury

6 Apley s Compression - Distraction Test meniscal testing truth Apley s Compression Test Hard downward pressure is applied with rotation Pain indicates a meniscal injury Apley s Distraction Test Traction is applied with rotation Pain will occur if there is damage to the capsule or ligaments No pain will occur if it is meniscal TEST Citation Sensitivity Specificity MRI Jackson 93% 90% McMurray Evans 20% 91% McMurray Fowler 29% 96% Apley (compression) Fowler 16% 80% Joint Line Tenderness Fowler 85% 30% Pain on Forced Flexion Fowler 51% 70% Block to Extension Fowler 44% 86% Sensitivity - % patients correctly identified by the test - good at ruling out Specificity - % patients correctly not identified by the test - good at ruling in MRIs are about 90% accurate Operative vs. Conservative Management Small, peripheral, stable tears that are not causing functional limitations may respond to non-surgical intervention uniform black signal at the tip of red arrow white signal within black signal at the tip of the red arrow Part 3: Surgical Considerations Meniscal Surgical Options Partial Menisectomy Meniscal Repair Meniscal Allograft

7 Meniscal Surgical Indications Meniscal Repair Techniques Partial Menisectomies complex tears in avascular one Large flap or radial tears degenerative tears irreparable tears Meniscal Repair young patients - all tears except inner 4-6 mm stable knees complete longitudinal tears greater than 1 cm in length High % of success Seems to be independent of age, length of tear, or time since injury 90% success in ACL reconstructions; 30-40% failure in ACL deficient knees Meniscal Repair Techniques Outside-In Meniscal Repair Sutures Inside Out: middle and posterior tears Outside In: anterior tears Arrows All inside barbs, harpoons, darts Inside-Out Meniscal Repair All Inside Meniscal Arrow Repair Meniscal arrows or darts are tiny biodegradable polymer harpoons that hold together the torn portions of a meniscal tear until the fragments join together and the arrow dissolves.

8 Meniscal Healing Prognosis Part 3: Post-Operative Rehabilitation GOOD PROGNOSIS Younger Patient (under 35) Peripheral Damage Longitudinal Tear Short Tear Acute Injury (bloody effusion) Stable Knee POOR PROGNOSIS Older Patient Central Damage Complete Tear Bucket Handle Tear Chronic Injury Unstable Knee Pro-Active Post-Arthroscopic Knee Rehab Pro-Active Post-Arthroscopic Knee Rehab BOTH the surgical procedure and subsequent clinical rehabilitation influences the rate and extent of recovery Hughston, 1980 The earlier AROM is allowed, the earlier full ROM is achieved Sherman, 1983 Patients need post-operative physical therapy to normalie motor control, muscular strength, and gait Durand, 1991 and 1993 Supervised rehab facilitates successful outcomes Moffett, APMR, 1994 Timm, 1988 retrospective study on 5,000+ post-op knee cases POST-OPERATIVE CARE SUCCESS RATE No exercise 0% Home exercise instruction only 9% Supervised isotonic exercise program 48% Supervised isokinetic and comprehensive rehab 92% Physical Therapy Efficacy Physical Therapy Efficacy No differences between home program and HEP with six weeks of supervised physical therapy according to a variety of outcome measures Outcomes questionnaires Days return to work Gait kinematics Hop/Jump tests Vervest AM, et al. Effectiveness of physiotherapy after menisectomy. Knee Surg Sports Traumatol Arthrosc. 1999; 7(6): Physiotherapy group showed significantly better results than the control group in regards to patient satisfaction and functional outcomes Goodwin PC et al, Phys Ther 83: , 2003

9 post-op meniscal rehab considerations post-op menisectomy rehabilitation considerations Proactive approach Protected arcs of motion Varus-valgus stress Rotational torque OKC vs. CKC Time to Return Excisions: 4-6 weeks Repairs: 4-6 months Control post-op pain/swelling FWB when gait normalies ROM and strengthening to tolerance Return to activity typically takes 3-6 weeks post-op meniscal repair rehab considerations post-op meniscal repair rehab considerations General Considerations and Influences Site of repair Red vs. white Complex vs. peripheral Associated pathologies General Considerations and Influences Age Athletic or ADL goals Surgeon Philosophy post-op meniscal repair rehab considerations Post-operative Rehab Protocol Immediate protected motion post-op (0-90 for 4 wks) Locked in full extension if early weight bearing; FWB at 4-6 wks Neoprene compression sleeve to minimie swelling and provide support Slow, gradual progressions based on objective status No resistive flexion for 2 months No squats or twisting activities for 3-6 months 4-6 month restriction on return to athletics Need acrobat reader software to download and print. Free link is also at web site

10 Remember a good clinician knows when to ignore the protocol s suggestions meniscal allograft rehabilitation Locked in full extension first 6-8 weeks Progressive weight bearing over 6-12 weeks Slow gradual progression 6-12 months to return to full, unrestricted activity Frit JM, Irrgang JJ, Harner CD. Rehabilitation following allograft meniscal transplantation: a review of the literature and case study. J Orthop Sports Phys Ther Aug; 24(2): References

The Meniscus. History. Anatomy. Anatomy. Blood Supply. Attachments

The Meniscus. History. Anatomy. Anatomy. Blood Supply. Attachments History The Meniscus W. Randall Schultz, MD, MS Austin, TX January 23, 2016 Meniscus originally thought to represent vestigial tissue 1883 first reported meniscal repair (Annandale) Total menisectomy treatment

More information

Rehab Considerations: Meniscus

Rehab Considerations: Meniscus Rehab Considerations: Meniscus Steve Cox, PT, DPT Department of Orthopaedics School of Medicine University of Texas Health Science Center at San Antonio 1 -Anatomy/ Function/ Injuries -Treatment Options

More information

ACL Athletic Career. ACL Rupture - Warning Features Intensive pain Immediate swelling Locking Feel a Pop Dead leg Cannot continue to play

ACL Athletic Career. ACL Rupture - Warning Features Intensive pain Immediate swelling Locking Feel a Pop Dead leg Cannot continue to play FIMS Ambassador Tour to Eastern Europe, 2004 Belgrade, Serbia Montenegro Acute Knee Injuries - Controversies and Challenges Professor KM Chan OBE, JP President of FIMS Belgrade ACL Athletic Career ACL

More information

Epidemiology. Meniscal Injury & Repair. Meniscus Anatomy. Meniscus Anatomy

Epidemiology. Meniscal Injury & Repair. Meniscus Anatomy. Meniscus Anatomy Epidemiology 60-70/100,000 per year Meniscal Injury & Repair Arthroscopic Mensiscectomy One of the most common orthopaedic procedures 20% of all surgeries at some centers Male:Female ratio - 2-4:1 Younger

More information

Rehabilitation Guidelines for Meniscal Repair

Rehabilitation Guidelines for Meniscal Repair Rehabilitation Guidelines for Meniscal Repair The knee is the body's largest joint, and the place where the femur, tibia, and patella meet to form a hinge-like joint. These bones are supported by a large

More information

Ligamentous and Meniscal Injuries: Diagnosis and Management

Ligamentous and Meniscal Injuries: Diagnosis and Management Ligamentous and Meniscal Injuries: Diagnosis and Management Daniel K Williams, MD Franciscan Physician Network Orthopedic Specialists September 29, 2017 No Financial Disclosures INTRODUCTION Overview of

More information

The Knee. Prof. Oluwadiya Kehinde

The Knee. Prof. Oluwadiya Kehinde The Knee Prof. Oluwadiya Kehinde www.oluwadiya.sitesled.com The Knee: Introduction 3 bones: femur, tibia and patella 2 separate joints: tibiofemoral and patellofemoral. Function: i. Primarily a hinge joint,

More information

W. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco

W. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco Knee Pain And Injuries In Adults W. Dilworth Cannon, M.D. Professor of Clinical Orthopaedic Surgery University of California San Francisco Pain Control Overview Narcotics rarely necessary after 1 st 1-2

More information

The Knee. Two Joints: Tibiofemoral. Patellofemoral

The Knee. Two Joints: Tibiofemoral. Patellofemoral Evaluating the Knee The Knee Two Joints: Tibiofemoral Patellofemoral HISTORY Remember the questions from lecture #2? Girth OBSERVATION TibioFemoral Alignment What are the consequences of faulty alignment?

More information

Prevention and Treatment of Injuries. Anatomy. Anatomy. Chapter 20 The Knee Westfield High School Houston, Texas

Prevention and Treatment of Injuries. Anatomy. Anatomy. Chapter 20 The Knee Westfield High School Houston, Texas Prevention and Treatment of Injuries Chapter 20 The Knee Westfield High School Houston, Texas Anatomy MCL, Medial Collateral Ligament LCL, Lateral Collateral Ligament PCL, Posterior Cruciate Ligament ACL,

More information

On Field Assessment and Management of Acute Knee Injuries: A Physiotherapist s Perspective

On Field Assessment and Management of Acute Knee Injuries: A Physiotherapist s Perspective On Field Assessment and Management of Acute Knee Injuries: A Physiotherapist s Perspective Jessica Condliffe Physiotherapist / Clinic Manager TBI Health Wellington Presentation Outline Knee anatomy review

More information

The Knee. Tibio-Femoral

The Knee. Tibio-Femoral The Knee Tibio-Femoral Osteology Distal Femur with Proximal Tibia Largest Joint Cavity in the Body A modified hinge joint with significant passive rotation Technically, one degree of freedom (Flexion/Extension)

More information

Differential Diagnosis

Differential Diagnosis Case 31yo M who sustained an injury to L knee while playing Basketball approximately 2 weeks ago. He describes pivoting and hyperextending his knee, which swelled over the next few days. He now presents

More information

MRI of the Knee: Part 2 - menisci. Mark Anderson, M.D. University of Virginia Health System

MRI of the Knee: Part 2 - menisci. Mark Anderson, M.D. University of Virginia Health System MRI of the Knee: Part 2 - menisci Mark Anderson, M.D. University of Virginia Health System Learning Objectives At the end of the presentation, each participant should be able to: describe the normal anatomy

More information

What is Medial Plica Syndrome?

What is Medial Plica Syndrome? What is Medial Plica Syndrome? It is a congenital disorder in which the thin wall of fibrous tissue extends from the synovial capsule of the knee. Pain usually occurs when the synovial capsule becomes

More information

Medical Practice for Sports Injuries and Disorders of the Knee

Medical Practice for Sports Injuries and Disorders of the Knee Sports-Related Injuries and Disorders Medical Practice for Sports Injuries and Disorders of the Knee JMAJ 48(1): 20 24, 2005 Hirotsugu MURATSU*, Masahiro KUROSAKA**, Tetsuji YAMAMOTO***, and Shinichi YOSHIDA****

More information

Knee Injury Assessment

Knee Injury Assessment Knee Injury Assessment Clinical Anatomy p. 186 Femur Medial condyle Lateral condyle Femoral trochlea Tibia Intercondylar notch Tibial tuberosity Tibial plateau Fibula Fibular head Patella Clinical Anatomy

More information

9/24/2012. Greg Bennett, PT, DSc Excel Physical Therapy Marymount University

9/24/2012. Greg Bennett, PT, DSc Excel Physical Therapy Marymount University Greg Bennett, PT, DSc Excel Physical Therapy Marymount University Hx often diagnostic Least to most threatening Sx trump exam Develop consistent routine Don t inflame inflamed tissue 1 1. ESTABLISH OR

More information

Knee Joint Assessment and General View

Knee Joint Assessment and General View Knee Joint Assessment and General View Done by; Mshari S. Alghadier BSc Physical Therapy RHPT 366 m.alghadier@sau.edu.sa http://faculty.sau.edu.sa/m.alghadier/ Functional anatomy The knee is the largest

More information

Meniscus Tears. Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella).

Meniscus Tears. Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). Meniscus Tears Information on meniscus tears is also available in Spanish: Desgarros de los meniscus (topic.cfm?topic=a00470) and Portuguese: Rupturas do menisco (topic.cfm?topic=a00754). Meniscus tears

More information

Rehabilitation Guidelines for Knee Arthroscopy

Rehabilitation Guidelines for Knee Arthroscopy Rehabilitation Guidelines for Knee Arthroscopy The knee is the body's largest joint, and the place where the femur, tibia, and patella meet to form a hinge-like joint. These bones are supported by a large

More information

This presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribute.

This presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribute. 43 rd Annual Symposium on Sports Medicine UT Health Science Center San Antonio School of Medicine January 22-23, 2016 Intra-articular / Extra-synovial 38 mm length / 13 mm width Fan-shaped structure narrowest-midportion

More information

Anatomy and Sports Injuries of the Knee

Anatomy and Sports Injuries of the Knee Anatomy and Sports Injuries of the Knee I. Anatomy II. Assessment III. Treatment IV. Case Study V. Dissection Anatomy Not a hinge joint 6 degrees of freedom Flexion/Extension Rotation Translation Anatomy

More information

Meniscus Problems - Torn Meniscus Repair

Meniscus Problems - Torn Meniscus Repair Meniscus Problems - Torn Meniscus Repair The two crescent-shaped menisci in each knee absorb shock, disperse weight, and reduce friction when the knee moves. Activities such as walking or jumping transfer

More information

ACL AND PCL INJURIES OF THE KNEE JOINT

ACL AND PCL INJURIES OF THE KNEE JOINT ACL AND PCL INJURIES OF THE KNEE JOINT Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery,

More information

PRINCIPLES OF EXAMNINIG THE KNEE

PRINCIPLES OF EXAMNINIG THE KNEE Welcome! Pignon, Haiti IS IT. GOOD MORNING LORD! OR GOOD LORD, MORNING! PRINCIPLES OF EXAMNINIG THE KNEE Greg Bennett, PT, DSc Excel Physical Therapy Marymount University Rules Hx often diagnostic Least

More information

Physical Examination of the Knee

Physical Examination of the Knee History: Pain Traumatic vs. atraumatic Acute vs Chronic Mechanism of injury Swelling, catching, instability Previous evaluation and treatment General Setup Examine standing, sitting and supine Evaluate

More information

Rehabilitation Guidelines for Meniscal Repair

Rehabilitation Guidelines for Meniscal Repair UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Meniscal Repair There are two types of cartilage in the knee, articular cartilage and cartilage. Articular cartilage is made up of collagen,

More information

and K n e e J o i n t Is the most complicated joint in the body!!!!

and K n e e J o i n t Is the most complicated joint in the body!!!! K n e e J o i n t K n e e J o i n t Is the most complicated joint in the body!!!! 1-Consists of two condylar joints between: A-The medial and lateral condyles of the femur and The condyles of the tibia

More information

Rehabilitation Guidelines for Knee Arthroscopy

Rehabilitation Guidelines for Knee Arthroscopy UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Knee Arthroscopy Arthroscopy is a common surgical procedure in which a joint is viewed using a small camera. This technique allows the surgeon

More information

Anterior Cruciate Ligament Surgery

Anterior Cruciate Ligament Surgery Anatomy Anterior Cruciate Ligament Surgery Roger Ostrander, MD Andrews Institute Anatomy Anatomy Function Primary restraint to anterior tibial translation Secondary restraint to internal tibial rotation

More information

Knee Injuries. PSK 4U Mr. S. Kelly North Grenville DHS. Medial Collateral Ligament Sprain

Knee Injuries. PSK 4U Mr. S. Kelly North Grenville DHS. Medial Collateral Ligament Sprain Knee Injuries PSK 4U Mr. S. Kelly North Grenville DHS Medial Collateral Ligament Sprain Result from either a direct blow from the lateral side in a medial direction or a severe outward twist Greater injury

More information

Physical Examination of the Knee

Physical Examination of the Knee History: Pain Traumatic vs. atraumatic? Acute vs Chronic Previous procedures done on the knee? Swelling, catching, instability General Setup Examine standing, sitting and supine Evaluate gait Examine hip

More information

ADVANCED IMAGING OF THE KNEE

ADVANCED IMAGING OF THE KNEE MENISCAL ANATOMY ADVANCED IMAGING OF THE KNEE MENISCAL ABNORMALITIES MENISCAL FUNCTION MENISCAL FUNCTION load transmission shock absorption stability The menisci DO NOT function as primary stabilizers

More information

Post-injury painful and locked knee

Post-injury painful and locked knee H R J Post-injury painful and locked knee, p. 54-59 Clinical Case - Test Yourself Musculoskeletal Imaging Post-injury painful and locked knee Ioannis I. Daskalakis 1, 2, Apostolos H. Karantanas 1, 2 1

More information

MENISCAL INJURIES. (copyright s h palmer 2009) MENISCAL FUNCTION

MENISCAL INJURIES. (copyright s h palmer 2009) MENISCAL FUNCTION (copyright s h palmer 2009) MENISCAL FUNCTION MENISCAL INJURIES Menisci are important for weight bearing, load distribution, joint stability and proprioception. Figure 1: A normal medial meniscus Any load

More information

Diagnosis and Management of Knee Conditions. Jenny Love / Lynn Robertson AFLAR Oct 2009

Diagnosis and Management of Knee Conditions. Jenny Love / Lynn Robertson AFLAR Oct 2009 Diagnosis and Management of Knee Conditions Jenny Love / Lynn Robertson AFLAR Oct 2009 AIMS Review 4 common Knee Conditions: Anterior knee pain Meniscal Injuries Ligament injuries ACL Osteoarthritis Discuss

More information

No Disclosures. Topics. Pediatric ACL Tears

No Disclosures. Topics. Pediatric ACL Tears Knee Injuries in Skeletally Immature Athletes No Disclosures Zachary Stinson, M.D. 2 Topics ACL Tears and Tibial Eminence Fractures Meniscus Injuries Discoid Meniscus Osteochondritis Dessicans Patellar

More information

New Evidence Suggests that Work Related Knee Pain with Degenerative Complications May Not Require Surgery

New Evidence Suggests that Work Related Knee Pain with Degenerative Complications May Not Require Surgery 4 th Quarter 2017 New Evidence Suggests that Work Related Knee Pain with Degenerative Complications May Not Require Surgery By: Michael Erdil MD, FACOEM Introduction It is estimated there are approximately

More information

RN(EC) ENC(C) GNC(C) MN ACNP *** MECHANISM OF INJURY.. MOST IMPORTANT *** - Useful in determining mechanism of injury / overuse

RN(EC) ENC(C) GNC(C) MN ACNP *** MECHANISM OF INJURY.. MOST IMPORTANT *** - Useful in determining mechanism of injury / overuse HISTORY *** MECHANISM OF INJURY.. MOST IMPORTANT *** Age of patient Sport / Occupation - Certain conditions are more prevalent in particular age groups (Osgood Schlaters in youth / Degenerative Joint Disease

More information

SOFT TISSUE INJURIES OF THE KNEE: Primary Care and Orthopaedic Management

SOFT TISSUE INJURIES OF THE KNEE: Primary Care and Orthopaedic Management SOFT TISSUE INJURIES OF THE KNEE: Primary Care and Orthopaedic Management Gauguin Gamboa Australia has always been a nation where emphasis on health and fitness has resulted in an active population engaged

More information

Knee Joint Anatomy 101

Knee Joint Anatomy 101 Knee Joint Anatomy 101 Bone Basics There are three bones at the knee joint femur, tibia and patella commonly referred to as the thighbone, shinbone and kneecap. The fibula is not typically associated with

More information

TOTAL KNEE ARTHROPLASTY (TKA)

TOTAL KNEE ARTHROPLASTY (TKA) TOTAL KNEE ARTHROPLASTY (TKA) 1 Anatomy, Biomechanics, and Design 2 Femur Medial and lateral condyles Convex, asymmetric Medial larger than lateral 3 Tibia Tibial plateau Medial tibial condyle: concave

More information

Medical Diagnosis for Michael s Knee

Medical Diagnosis for Michael s Knee Medical Diagnosis for Michael s Knee Introduction The following report mainly concerns the diagnosis and treatment of the patient, Michael. Given that Michael s clinical problem surrounds an injury about

More information

Introduction Knee Anatomy and Function Making the Diagnosis

Introduction Knee Anatomy and Function Making the Diagnosis Introduction Knee injuries are a very common problem among active individuals. It is important for us to understand how your knee was injured. Most knee injuries are associated with non-contact mechanisms.

More information

Unicompartmental Knee Resurfacing

Unicompartmental Knee Resurfacing Disclaimer This movie is an educational resource only and should not be used to manage knee pain. All decisions about the management of knee pain must be made in conjunction with your Physician or a licensed

More information

FUNCTIONAL ANATOMY: Knee and Leg

FUNCTIONAL ANATOMY: Knee and Leg ACSM Team Physician Course San Antonio Feb 2015 FUNCTIONAL ANATOMY: Knee and Leg Marlene DeMaio, MD Professor, Orthopaedic Surgery Marshall University VAMC Huntington, WV Mary Lloyd Ireland, MD Professor

More information

Knee: Meniscus Back to Basics

Knee: Meniscus Back to Basics Knee: Meniscus Back to Basics Kyung Jin Suh kyungjin.suh@gmail.com Doctor Radiology, Daegu, KOREA Medial Lateral 7.7 10.2 11.6 9.6 10.6 mm Posterior > Anterior horn 10.6 mm Posterior = Anterior horn Medial

More information

Medial Meniscal Root Tears: When to rehab? When to repair? When to debride. Christopher Betz, DO Orthopedics Sports Medicine Bristol, CT

Medial Meniscal Root Tears: When to rehab? When to repair? When to debride. Christopher Betz, DO Orthopedics Sports Medicine Bristol, CT Medial Meniscal Root Tears: When to rehab? When to repair? When to debride Christopher Betz, DO Orthopedics Sports Medicine Bristol, CT Disclosure Consultant Mitek Smith and Nephew-biologic patch Good

More information

Overview Ligament Injuries. Anatomy. Epidemiology Very commonly injured joint. ACL Injury 20/06/2016. Meniscus Tears. Patellofemoral Problems

Overview Ligament Injuries. Anatomy. Epidemiology Very commonly injured joint. ACL Injury 20/06/2016. Meniscus Tears. Patellofemoral Problems Overview Ligament Injuries Meniscus Tears Pankaj Sharma MBBS, FRCS (Tr & Orth) Consultant Orthopaedic Surgeon Manchester Royal Infirmary Patellofemoral Problems Knee Examination Anatomy Epidemiology Very

More information

Meniscal Root Tears: Evaluation, Imaging, and Repair Techniques

Meniscal Root Tears: Evaluation, Imaging, and Repair Techniques Meniscal Root Tears: Evaluation, Imaging, and Repair Techniques R O B E R T N A S C I M E N TO, M D, M S C H I E F OF S P O RT S M E D I C I N E & SH O U L D E R S U R G E RY N E W TO N- W E L L E S L

More information

ACL Rehabilitation and Return To Play

ACL Rehabilitation and Return To Play ACL Rehabilitation and Return To Play Seth Gasser, MD Director of Sports Medicine Florida Orthopaedic Institute Introduction Return to Play: the point in recovery from an injury when a person is safely

More information

Your Practice Online

Your Practice Online Your Practice Online Disclaimer P R E S E N T S - PATELLAR TENDON This movie is an educational resource only and should not be used to make a decision on Anterior Cruciate Ligament (ACL) Reconstruction.

More information

EVALUATION OBJECTIVES. Partial Menisectomy of an Intercollegiate Mid-Fielder Soccer Player. Chrissandra Perez ATPE 412

EVALUATION OBJECTIVES. Partial Menisectomy of an Intercollegiate Mid-Fielder Soccer Player. Chrissandra Perez ATPE 412 Partial Menisectomy of an Intercollegiate Mid-Fielder Soccer Player Chrissandra Perez ATPE 412 OBJECTIVES Give background on Meniscus Tears MOI Signs and Symptoms Differential Diagnosis Limitations of

More information

Joints. Judi Laprade. Illustrations from: Essential Clinical Anatomy 3 rd ed. (ECA3) Moore, K. and Agur, A. Lippincott Williams and Wilkins, 2007

Joints. Judi Laprade. Illustrations from: Essential Clinical Anatomy 3 rd ed. (ECA3) Moore, K. and Agur, A. Lippincott Williams and Wilkins, 2007 Slide 1 Joints Judi Laprade Illustrations from: Essential Clinical Anatomy 3 rd ed. (ECA3) Moore, K. and Agur, A. Lippincott Williams and Wilkins, 2007 Grant s Atlas of Anatomy 12 th ed. (GA12) Agur, A.

More information

Anterior Cruciate Ligament (ACL)

Anterior Cruciate Ligament (ACL) Anterior Cruciate Ligament (ACL) The anterior cruciate ligament (ACL) is one of the 4 major ligament stabilizers of the knee. ACL tears are among the most common major knee injuries in active people of

More information

Rehabilitation Guidelines for Anterior Cruciate Ligament (ACL) Reconstruction

Rehabilitation Guidelines for Anterior Cruciate Ligament (ACL) Reconstruction Rehabilitation Guidelines for Anterior Cruciate Ligament (ACL) Reconstruction The knee is the body's largest joint, and the place where the femur, tibia, and patella meet to form a hinge-like joint. These

More information

Case Report Double-Layered Lateral Meniscus Accompanied by Meniscocapsular Separation

Case Report Double-Layered Lateral Meniscus Accompanied by Meniscocapsular Separation Case Reports in Orthopedics Volume 2015, Article ID 357463, 5 pages http://dx.doi.org/10.1155/2015/357463 Case Report Double-Layered Lateral Meniscus Accompanied by Meniscocapsular Separation Aki Fukuda,

More information

INTRODUCTION. Article Summary. The Question. Orthopedic Extremity/Foot-Ankle Journal Club. The Question the Study Proposes

INTRODUCTION. Article Summary. The Question. Orthopedic Extremity/Foot-Ankle Journal Club. The Question the Study Proposes Orthopedic Extremity/Foot-Ankle Journal Club Ed Mulligan, MS, PT, SCS, ATC Grapevine, TX 817-488-5159 ed.mulligan@healthsouth.com The diagnostic accuracy of a new clinical test (the Thessaly Test) for

More information

Oh My Aching Knee. Oh My Aching Knee WHO AM I? 10/15/2012. Jan Pieter Hommen, MD Orthopedic Surgeon Sports Medicine Arthroscopy Joint Replacements

Oh My Aching Knee. Oh My Aching Knee WHO AM I? 10/15/2012. Jan Pieter Hommen, MD Orthopedic Surgeon Sports Medicine Arthroscopy Joint Replacements Oh My Aching Knee Jan Pieter Hommen, MD Orthopedic Surgeon Sports Medicine Arthroscopy Joint Replacements Oh My Aching Knee Jan Pieter Hommen, MD Orthopedic Surgeon Sports Medicine Arthroscopy Joint Replacements

More information

Hip joint Type: Articulating bones:

Hip joint Type: Articulating bones: Ana (242 ) Hip joint Type: Synovial, ball & socket Articulating bones: Formed between head of femur and lunate surface of acetabulum of hip bone. Capsule: it is a strong fibrous sleeve connecting the articulating

More information

ACL RECONSTRUCTION HAMSTRING METHOD. Presents ACL RECONSTRUCTION HAMSTRING METHOD. Multimedia Health Education

ACL RECONSTRUCTION HAMSTRING METHOD. Presents ACL RECONSTRUCTION HAMSTRING METHOD. Multimedia Health Education HAMSTRING METHOD Presents HAMSTRING METHOD Multimedia Health Education Disclaimer Stephen J. Incavo MD This movie is an educational resource only and should not be used to make a decision on Anterior Cruciate

More information

Anterior Cruciate Ligament (ACL) Injuries

Anterior Cruciate Ligament (ACL) Injuries Anterior Cruciate Ligament (ACL) Injuries Mark L. Wood, MD The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. The incidence of ACL injuries is currently estimated

More information

Imaging the Knee 17/10/2017. Friction syndrome Common in runners or cyclists Fluid between ITB and Lateral femoral condyle

Imaging the Knee 17/10/2017. Friction syndrome Common in runners or cyclists Fluid between ITB and Lateral femoral condyle 17/10/2017 Imaging the Knee Alicia M. Yochum RN, DC, DACBR, RMSK Iliotibial Band Syndrome Ligamentous Tears (ACL, PCL, MCL, LCL) Meniscal Tears Cartilage Degeneration Quadriceps/Patellar tendinosis Osteochondral

More information

MCL Injuries: When and How to Repair Scott D. Mair, MD

MCL Injuries: When and How to Repair Scott D. Mair, MD MCL Injuries: When and How to Repair Scott D. Mair, MD Professor and Team Physician: Orthopaedic Surgery University of Kentucky School of Medicine Disclosure Institution: Research/Education Smith-Nephew

More information

Anterior Cruciate Ligament Injuries

Anterior Cruciate Ligament Injuries Anterior Cruciate Ligament Injuries One of the most common knee injuries is an anterior cruciate ligament sprain or tear.athletes who participate in high demand sports like soccer, football, and basketball

More information

A Patient s Guide to Knee Anatomy

A Patient s Guide to Knee Anatomy A Patient s Guide to Knee Anatomy 15195 Heathcote Blvd Suite 334 Haymarket, VA 20169 Phone: 703-369-9070 Fax: 703-369-9240 DISCLAIMER: The information in this booklet is compiled from a variety of sources.

More information

Knee Multiligament Rehabilitation

Knee Multiligament Rehabilitation Knee Multiligament Rehabilitation Orlando Valle, PT, MSPT, SCS, CSCS Director Ironman Sports Medicine Institute TMC Orlando.Valle@memorialhermann.org 4 Major Ligaments ACL PCL MCL LCL (PLC) Anatomy Function

More information

JF Rick Hammesfahr, MD

JF Rick Hammesfahr, MD Field Evaluation and Management of Non-Battle Related Knee and Ankle Injuries by the Advanced Tactical Practitioner (ATP) in the Austere Environment Part Two JF Rick Hammesfahr, MD Editor s Note: The following

More information

Knee Dislocation: Spectrum of Injury, Evolution of Treatment & Modern Outcomes

Knee Dislocation: Spectrum of Injury, Evolution of Treatment & Modern Outcomes Knee Dislocation: Spectrum of Injury, Evolution of Treatment & Modern Outcomes William M Weiss, MD MSc FRCSC Orthopedic Surgery & Rehabilitation Sports Medicine, Arthroscopy & Extremity Reconstruction

More information

Orthopaedic Manual Physical Therapy Series Orthopaedic Manual Physical Therapy Series

Orthopaedic Manual Physical Therapy Series Orthopaedic Manual Physical Therapy Series THE KNEE Michael McMurray PT, DPT, OCS, FAAOMPT Orthopaedic Manual Physical Therapy Series Charlottesville 2017-2018 Reproduction Without Consent 1 Anterior Cruciate Ligament ACL 148714 reconstructions

More information

MENISCAL INJURY. Meniscus. Anterior Roots. Medial Meniscus. Lateral Meniscus. Posterior Roots. MRI and Arthroscopic Findings

MENISCAL INJURY. Meniscus. Anterior Roots. Medial Meniscus. Lateral Meniscus. Posterior Roots. MRI and Arthroscopic Findings Meniscus Anterior Roots MENISCAL INJURY MRI and Arthroscopic Findings Medial Meniscus AH PH PH AH Lateral Meniscus Rawiwan Pattaweerakul Naresuan University Hospital Posterior Roots Meniscus Normal Meniscus

More information

Financial Disclosure. Medial Collateral Ligament

Financial Disclosure. Medial Collateral Ligament Matthew Murray, M.D. UTHSCSA Sports Medicine Financial Disclosure Dr. Matthew Murray has no relevant financial relationships with commercial interests to disclose. Medial Collateral Ligament Most commonly

More information

General Concepts. Growth Around the Knee. Topics. Evaluation

General Concepts. Growth Around the Knee. Topics. Evaluation General Concepts Knee Injuries in Skeletally Immature Athletes Zachary Stinson, M.D. Increased rate and ability of healing Higher strength of ligaments compared to growth plates Continued growth Children

More information

Chapter 20 The knee and related structures

Chapter 20 The knee and related structures Chapter 20 The knee and related structures Athletic Training Spring 2014 Jihong Park Bones & joints Femur, tibia, fibula, & patella Femur & tibia Weight bearing & muscle attachment Patella functions Anterior

More information

The Knee Joint By Prof. Dr. Muhammad Imran Qureshi

The Knee Joint By Prof. Dr. Muhammad Imran Qureshi The Knee Joint By Prof. Dr. Muhammad Imran Qureshi Structurally, it is the Largest and the most complex joint in the body because of the functions that it performs: Allows mobility (flexion/extension)

More information

Treatment of meniscal lesions and isolated lesions of the anterior cruciate ligament of the knee in adults

Treatment of meniscal lesions and isolated lesions of the anterior cruciate ligament of the knee in adults QUICK REFERENCE GUIDE Treatment of meniscal s and isolated s of the anterior cruciate ligament of the knee in adults June 2008 AIM OF THE GUIDELINES To encourage good practices in the areas of meniscal

More information

l. Initiate early proprioceptive activity and progress by means of distraction techniques: i. eyes open to eyes closed ii. stable to unstable m.

l. Initiate early proprioceptive activity and progress by means of distraction techniques: i. eyes open to eyes closed ii. stable to unstable m. Meniscus Repair 1. Defined a. Sutures or bioabsorbable fixation devices (arrows, darts, screws, etc.) bring together and fixate the edges of a tear in the meniscus in order to maintain the shock absorption

More information

40 th Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure

40 th Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure 40 th Annual Symposium on Sports Medicine Travis Murray, MD Assistant Professor University of Texas Health Science Center San Antonio Knee Injuries In The Pediatric Athlete Disclosure Dr. Travis Murray

More information

The Remedy Report LifeBridge Health Sports Medicine Newsletter January 2006

The Remedy Report LifeBridge Health Sports Medicine Newsletter January 2006 In this issue... ACL's, High Ankle Sprains and Stingers, Oh My... Meniscus Injuries and Treatment Lowering Your Risk for a Cold Finger Injuries in Basketball Players Our Sponsors The Remedy Report LifeBridge

More information

ANTERIOR CRUCIATE LIGAMENT INJURY

ANTERIOR CRUCIATE LIGAMENT INJURY ANTERIOR CRUCIATE LIGAMENT INJURY WHAT IS THE ANTERIOR CRUCIATE LIGAMENT? The anterior cruciate ligament (ACL) is one of four major ligaments that stabilizes the knee joint. A ligament is a tough band

More information

Lateral knee injuries

Lateral knee injuries Created as a free resource by Clinical Edge Based on Physio Edge podcast episode 051 with Matt Konopinski Get your free trial of online Physio education at Orthopaedic timeframes Traditionally Orthopaedic

More information

Knee Movement Coordination Deficits. ICD-9-CM: Sprain of cruciate ligament of knee

Knee Movement Coordination Deficits. ICD-9-CM: Sprain of cruciate ligament of knee 1 Knee Movement Coordination Deficits Anterior Cruciate Ligament ACL Tear ICD-9-CM: 844.2 Sprain of cruciate ligament of knee ACL Insufficiency ICD-9-CM: 717.83 Old disruption of anterior cruciate ligament

More information

Objectives. The BIG Joint. Case 1. Boney Architecture. Presenter Disclosure Information. Common Knee Problems

Objectives. The BIG Joint. Case 1. Boney Architecture. Presenter Disclosure Information. Common Knee Problems 3:30 4:15 pm Common Knee Problems SPEAKER Christopher J. Visco, MD Presenter Disclosure Information The following relationships exist related to this presentation: Christopher J. Visco, MD: Speaker s Bureau

More information

42 nd Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure

42 nd Annual Symposium on Sports Medicine. Knee Injuries In The Pediatric Athlete. Disclosure 42 nd Annual Symposium on Sports Medicine Travis Murray, MD Assistant Professor University of Texas Health Science Center San Antonio January 23, 2015 Knee Injuries In The Pediatric Athlete Disclosure

More information

What is the most effective MRI specific findings for lateral meniscus posterior root tear in ACL injuries

What is the most effective MRI specific findings for lateral meniscus posterior root tear in ACL injuries What is the most effective MRI specific findings for lateral meniscus posterior root tear in ACL injuries Kazuki Asai 1), Junsuke Nakase 1), Kengo Shimozaki 1), Kazu Toyooka 1), Hiroyuki Tsuchiya 1) 1)

More information

A Patient s Guide to Knee Anatomy. Stephanie E. Siegrist, MD, LLC

A Patient s Guide to Knee Anatomy. Stephanie E. Siegrist, MD, LLC A Patient s Guide to Knee Anatomy Hands, shoulders, knees and toes (and elbows and ankles, too!) Most bone and joint conditions have several treatment options. The best treatment for you is based on your

More information

FAI syndrome with or without labral tear.

FAI syndrome with or without labral tear. Case This 16-year-old female, soccer athlete was treated for pain in the right groin previously. Now has acute onset of pain in the left hip. The pain was in the groin that was worse with activities. Diagnosis

More information

This presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribution.

This presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribution. 42 ND Annual Symposium on Sports Medicine UT Health Science Center San Antonio School of Medicine January 22-24, 2015 PCL injuries- only 5 to 10% of all knee ligament injuries. Incidence of PCL injury

More information

Copyright 2012 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill/Irwin

Copyright 2012 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill/Irwin CHAPTER 8: THE LOWER EXTREMITY: KNEE, ANKLE, AND FOOT KINESIOLOGY Scientific Basis of Human Motion, 12 th edition Hamilton, Weimar & Luttgens Presentation Created by TK Koesterer, Ph.D., ATC Humboldt State

More information

Grant H Garcia, MD Sports and Shoulder Surgeon

Grant H Garcia, MD Sports and Shoulder Surgeon What to Expect from your Anterior Cruciate Ligament Reconstruction Surgery A Guide for Patients Grant H Garcia, MD Sports and Shoulder Surgeon Important Contact Information Grant Garcia, MD Wallingford:

More information

Biomechanics of the Knee. Valerie Nuñez SpR Frimley Park Hospital

Biomechanics of the Knee. Valerie Nuñez SpR Frimley Park Hospital Biomechanics of the Knee Valerie Nuñez SpR Frimley Park Hospital Knee Biomechanics Kinematics Range of Motion Joint Motion Kinetics Knee Stabilisers Joint Forces Axes The Mechanical Stresses to which

More information

MRI KNEE WHAT TO SEE. Dr. SHEKHAR SRIVASTAV. Sr.Consultant KNEE & SHOULDER ARTHROSCOPY

MRI KNEE WHAT TO SEE. Dr. SHEKHAR SRIVASTAV. Sr.Consultant KNEE & SHOULDER ARTHROSCOPY MRI KNEE WHAT TO SEE Dr. SHEKHAR SRIVASTAV Sr.Consultant KNEE & SHOULDER ARTHROSCOPY MRI KNEE - WHAT TO SEE MRI is the most accurate and frequently used diagnostic tool for evaluation of internal derangement

More information

STATE OF THE ART OF ACL SURGERY (Advancements that have had an impact)

STATE OF THE ART OF ACL SURGERY (Advancements that have had an impact) STATE OF THE ART OF ACL SURGERY (Advancements that have had an impact) David Drez, Jr., M.D. Clinical Professor of Orthopaedics LSU School of Medicine Financial Disclosure Dr. David Drez has no relevant

More information

The examination of the painful knee. Maja K Artandi, MD, FACP Clinical Associate Professor of Medicine Stanford University

The examination of the painful knee. Maja K Artandi, MD, FACP Clinical Associate Professor of Medicine Stanford University The examination of the painful knee Maja K Artandi, MD, FACP Clinical Associate Professor of Medicine Stanford University Objectives of the talk By the end of this talk you will know The important anatomy

More information

Anterior Cruciate Ligament (ACL) Rehabilitation

Anterior Cruciate Ligament (ACL) Rehabilitation Thomas D. Rosenberg, M.D. Vernon J. Cooley, M.D. Anterior Cruciate Ligament (ACL) Rehabilitation Dear Enclosed you will find a copy of our Anterior Cruciate Ligament (ACL) Rehabilitation program and the

More information

Goals &Objectives. 1. Review the anatomy of the knee 2. Practice your hands-on skills 3. By the end of the workshop:

Goals &Objectives. 1. Review the anatomy of the knee 2. Practice your hands-on skills 3. By the end of the workshop: Clinical Knee Exam Goals &Objectives 1. Review the anatomy of the knee 2. Practice your hands-on skills 3. By the end of the workshop: Be able to categorize knee injuries Understand the significance of

More information

Case Presentation. Treatment of Post-Operative Knee Motion Complications. Case Presentation #JM2801. Case Presentation #JM2801

Case Presentation. Treatment of Post-Operative Knee Motion Complications. Case Presentation #JM2801. Case Presentation #JM2801 Knee Motion Complications Kevin E Wilk, PT, DPT,FAPTA Champion Sports Medicine Case Presentation 20 year old college running back (DII Program) ACL injury, MCL sprain grade II, medial meniscus, meniscocapsular

More information