scholarly journals A Rare Cause of Anterior Knee Pain and Limitation of Knee Extension: Symptomatic Infrapatellar Plica: Case Report

2017 ◽  
Vol 25 (1) ◽  
pp. 1-5
Author(s):  
Bülent KARSLIOĞLU ◽  
Yusuf ERDEM ◽  
Taner DANDİNOĞLU
2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Patrick Haubruck ◽  
Ulf Brunnemer ◽  
Arash Moghaddam ◽  
Gerhard Schmidmaier

A case of an adolescent female patient who suffered from first grade open multi-fragment fracture of the tibia (AO42-C2) with a large hypermobile intermediate fragment is presented in this case report. Intramedullary nailing of the tibia remains the treatment of choice despite a high risk of malformation and anterior knee pain especially in multi-fragment fractures. Here the suprapatellar approach as a semiextended nailing technique seems favorable. The specialty in our case was an early change of procedures necessary due to persistent swelling during external fixation based on the hypermobile intermediate fragment. Decision in favor of this surgical technique was conducted in order to achieve beneficial alignment and union while protecting the softtissue despite the hypermobile intermediate fragment and decrease the risk of anterior knee pain. In our case we achieved successful alignment and proper bone healing without any signs of anterior knee pain or limitations in the range of motion of the knee. With this report we would like to recommend the suprapatellar approach as a favorable alternative in intramedullary nailing in this type of fracture also in young patients.


The Knee ◽  
2003 ◽  
Vol 10 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Jaikumar Relwani ◽  
Danielle Factor ◽  
Fred Khan ◽  
Amitava Dutta

2012 ◽  
Vol 21 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Jihong Park ◽  
Terry L. Grindstaff ◽  
Joe M. Hart ◽  
Jay N. Hertel ◽  
Christopher D. Ingersoll

Context:Weight-bearing (WB) and non-weight-bearing (NWB) exercises are commonly used in rehabilitation programs for patients with anterior knee pain (AKP).Objective:To determine the immediate effects of isolated WB or NWB knee-extension exercises on quadriceps torque output and activation in individuals with AKP.Design:A single-blind randomized controlled trial.Setting:Laboratory.Participants:30 subjects with self-reported AKP.Interventions:Subjects performed a maximal voluntary isometric contraction (MVIC) of the quadriceps (knee at 90°). Maximal voluntary quadriceps activation was quantified using the central activation ratio (CAR): CAR = MVIC/(MVIC + superimposed burst torque). After baseline testing, subjects were randomized to 1 of 3 intervention groups: WB knee extension, NWB knee extension, or control. WB knee-extension exercise was performed as a sling-based exercise, and NWB knee-extension exercise was performed on the Biodex dynamometer. Exercises were performed in 3 sets of 5 repetitions at approximately 55% MVIC. Measurements were obtained at 4 times: baseline and immediately and 15 and 30 min postexercise.Main Outcome Measures:Quadriceps torque output (MVIC: N·m/Kg) and quadriceps activation (CAR).Results:No significant differences in the maximal voluntary quadriceps torque output (F2,27 = 0.592, P = .56) or activation (F2,27 = 0.069, P = .93) were observed among the 3 treatment groups.Conclusions:WB and NWB knee-extension exercises did not acutely change quadriceps torque output or activation. It may be necessary to perform exercises over a number of sessions and incorporate other disinhibitory interventions (eg, cryotherapy) to observe acute changes in quadriceps torque and activation.


2018 ◽  
Vol 7 (5) ◽  
pp. e575-e588 ◽  
Author(s):  
Thomas Victor Smallman ◽  
Oliver Torben Portner ◽  
Amos Race ◽  
Kris Shekitka ◽  
Ken Mann

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Dharmendra K. Singh ◽  
Heena Rajani ◽  
Mukul Sinha ◽  
Amit Katyan ◽  
Saurabh Suman ◽  
...  

Author(s):  
Tim Evens ◽  
Jerome Danoff

Background: Among competitive cyclists, anterior knee pain is a common overuse injury. Alignment of the rider on the bicycle and the loading pattern on the pedals are proposed as factors in this pain. The patient was a 23-year-old competitive female cyclist who was riding up to 200 miles weekly and had developed bilateral anterior knee pain within the 3 months preceding our examination. The purpose of this case report is to demonstrate the effectiveness of adjusting this patient’s static alignment (ie. position while seated on bicycle, but not actively pedaling) on the bike and modifying her habitual pedaling pattern. Methods: The patient was analyzed using both static and dynamic measures of alignment while on her bicycle. Her bicycle seat was raised and moved rearward, and her pedaling force output was analyzed using a Computrainer™. Over a 4-week period, she was taught to modify her pedaling force using video biofeedback. Outcomes: After adjustments and training, she could ride for over 3.5 hours without knee pain. Visual analog scale pain score improved from 6/10 to 0/10; Lower Extremity Functional Score improved from 65 to 79; and Knee Injury and Osteoarthritis Outcome Score improved from 81 to 98.5. Clinical Relevance: This case illustrates how application of biomechanical principles and training in pedaling movement patterns can be effective at eliminating knee pain in competitive cyclists. While rest, decreased training volume, and appropriate medication should be considered as treatment components, we believe the initial treatment for competitive cyclists should include biomechanical evaluation of alignment and pedaling pattern.


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