PatellofemorPatellofemoral Injuriesal Injuries

Taelar Shelton, MS, ATC, Taelar Shelton, MS, ATC, AT/LAT/L

Patellar FracturePatellar Fracture

MOI: direct or indirect MOI: direct or indirect trauma, severe pull of the trauma, severe pull of the patellar tendon when the patellar tendon when the knee is semi-flexed or a knee is semi-flexed or a fall on the knee fall on the knee

S&S: hemorrhage, joint S&S: hemorrhage, joint effusion, swelling, capsular effusion, swelling, capsular tearing, separation of tearing, separation of bone fragmnetsbone fragmnets

Rx: x-ray conformation, ice Rx: x-ray conformation, ice with compression, splint with compression, splint and crutches for walking, and crutches for walking, referral to doctor, usually referral to doctor, usually immobilized for 2-3 immobilized for 2-3 monthsmonths

Subluxation/Dislocation Subluxation/Dislocation of the Patellaof the Patella

MOI- plant and twistMOI- plant and twist S&S, obvious deformity, S&S, obvious deformity,

usually lateral usually lateral dislocation, VMO dislocation, VMO weakness, decrease in weakness, decrease in function, swelling, P! function, swelling, P! and decreased ROM and decreased ROM

Rx- reduction by a Rx- reduction by a physician, immobilize, physician, immobilize, crutches, RICE, work on crutches, RICE, work on quad strengthening, quad strengthening, patellar tracking patellar tracking

Chondromalacia Chondromalacia

MOI- abnormal patellar MOI- abnormal patellar tracking, tibial rotation, tracking, tibial rotation, pronated foot, pronated foot, anteverted hip, anteverted hip, genuvalgum, gradual genuvalgum, gradual degenerationdegeneration

S&S- gradual S&S- gradual degeneration of degeneration of cartilage, p! with cartilage, p! with activities, swellingactivities, swelling

Rx- take care of the Rx- take care of the mechanism, rest prn, mechanism, rest prn, surgical interventionsurgical intervention

Larsen-Johansson Larsen-Johansson Disease Disease

MOI- at inferior pole of MOI- at inferior pole of the patella, repetitive the patella, repetitive strain of the patellar strain of the patellar tendontendon

S&S- swelling, P! and S&S- swelling, P! and x-rayx-ray

Rx- ice, rest, wait to Rx- ice, rest, wait to stress the knee until stress the knee until the growth plates are the growth plates are closed, isometrics closed, isometrics

Osgood-Schlatter Osgood-Schlatter Disease Disease

MOI- excessive strain MOI- excessive strain of the patellar tendon of the patellar tendon

S&S- enlarged tibial S&S- enlarged tibial tuberosity tuberosity

Rx- rest, ice after Rx- rest, ice after activities, strengthen activities, strengthen quads and hamstrings quads and hamstrings

Patellar Tendon Patellar Tendon Rupture Rupture

MOI- sudden powerful MOI- sudden powerful quad contraction, quad contraction, usually previous Hxusually previous Hx

S&S- obvious S&S- obvious deformity, swelling, P! deformity, swelling, P! and patella alta and patella alta

Rx- surgical repair Rx- surgical repair

Patellar TendonitisPatellar Tendonitis

MOI- jumping or kicking MOI- jumping or kicking that is repeated that is repeated frequently that leads to frequently that leads to degeneration degeneration

S&S- P! after activity S&S- P! after activity progresses to during and progresses to during and after then gets worse after then gets worse after activity after activity

Rx- avoid the mechanism, Rx- avoid the mechanism, use heating modalities use heating modalities prior to activity, ice after, prior to activity, ice after, transverse friction transverse friction massage, rest prnmassage, rest prn

IT Band Friction IT Band Friction SyndromeSyndrome

MOI- repetitive running MOI- repetitive running or biking, usually have or biking, usually have malalignment problems malalignment problems

S&S- p! on distal S&S- p! on distal insertion, +Ober’s test insertion, +Ober’s test

Rx- PRT, fix the Rx- PRT, fix the malalignment, take the malalignment, take the mechanism awaymechanism away

Collapsing KneeCollapsing Knee

MOI- week quads, MOI- week quads, chronic instability of chronic instability of the MCL, ACL or the MCL, ACL or posterior capsule; torn posterior capsule; torn meniscus; loose bodies; meniscus; loose bodies; subluxating patellasubluxating patella

S&S- knee feels like it S&S- knee feels like it will collapse or give will collapse or give wayway

Rx- quad Rx- quad strengthening, fix the strengthening, fix the mechanism of injurymechanism of injury