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Posterolateral corner to the knee (Posterolateral corner (Pacheco, Ayre,…
Posterolateral corner to the knee
Playing basketball
Landing injury
Hyperextended knee
Worried about missing tournament in Phillipines
American scouts for College
Incident just recently happened
Worried doesn't want to miss opportunity
Quiet spoken
Presented with knee brace
pain felt instantly
concerned due to friend tearing ACL.
worried about putting weight on the knee
Goal: to be fit in 7 weeks for games.
Scans showed no major damage
Dad concerned
19 year old male
Nil work
Pt come in leg heavily braced
reported pain the knee with some swelling
feels that knee will give away.
No P&N
Rules out peroneal nerve damage/compression
AROM/PROM observed restricted range due to guarding
Nil numbness in foot
meaning no ankle or foot muscle weakness
Observed pain and aching on all knee movement
Tender popliteus, gastric, biceps femoris, posterior capsule on palpation
Ruled out ligamentous, meniscus involvement
Dial test= positive result.
Fat pad irritation= positive
Contributing factors? possible poor landing mechanics
Poor hip and ankle control
lower limb alignment
Reduced muscle strength (hip, knee,ankle)
Rx: Unload fat pad with tape
Instantly felt better walking out with tape
Goal: 90% peak capacity by 7 weeks
Heavy emphasis on improving strength
Indication of Grade 1 due to ligamentous stability
Consistent with Pacheco study
MOI: landing from basketball (hyperextended knee)
Scan: kissing knee contusion injury
Irritation when passively moved into hyperextension
Links with scan of bone bruising
Compressing fat pad
tenderness outside of leg
Restricted movement/ wanted to protect
Relatively recent injury
Dad and son want to know instantly whats wrong
Eager to fix straight away
Concerns of problems due to ACL being intact
Happy for student interaction
No pain medications
Went for MRI showed bone bruising
MRI done at Blacktown
7 weeks to get results
Happy with student involvement
Explained healing process
Relay info with coaches/ possible team physiotherapist?
Ensure adjustments made to training
Tell them extent to injury and chances
Explain Rx plan with pt and admin team
pt understanding of continued physio to get to comp
Other concerns of pt addressed
Told 90% hopefully by 7 weeks
Due to bad bone bruising
Pt happy nothing majorly structural
still a chance to play
Posterolateral corner
Miller
found that pts report pain, struggle to weight bear
some report weakness and giving away
Objective findings show similar presentation
Pacheco, Ayre, Bollen
Conservative management for Grade 1's
Rule out ligamentous involvement
Working to build fundamental base of strength
Start addressing instability (found that with guarding)