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• W2073904058 abstract "HISTORY: 17 y.o. male presented with a painful and swollen left knee. On the morning of presentation he was playing air guitar and landed with a twisting motion of his left knee. He thought he felt something pop out in his left knee. It became painful and swollen right away. It was difficult for him to bear weight and to bend or straighten it. Prior to this, he had no history of knee injuries or pain. Patient was seen 5 days later for re-examination. He was still using crutches, unable to bear weight, and having difficulty bending and straightening fully. PHYSICAL EXAMINATION: Significant limp with knee held in flexion. Left knee exam showed a 3+ joint effusion. ROM was approximately 45 to 95 degrees with pain at extremes. Tenderness of the lateral retinaculum and superior lateral patella. No joint line tenderness. Ligamentous exam was limited due to the severe swelling. Minimal translation and good endpoint on Lachman, anterior/posterior drawer, valgus and varus stresses. Limited McMurray was negative. No neurovascular deficits. Follow up exam 5 days later was unchanged except for a slight decrease in effusion to 2 + and slightly increased ROM to 30 to 105 degrees. DIFFERENTIAL DIAGNOSIS: ACL tear Patellar dislocation OCD Patellar fracture Femur fracture Tibial plateau fracture Acute meniscus tear TEST AND RESULTS: Left knee radiographs: AP, lateral, tunnel and sunrise showed joint effusion, but no fracture or dislocation. MRI performed 2 weeks post injury: bone bruise of medial patellar facet and lateral femoral condyle. Large osteochondral fracture along anterior weight bearing portion of the left lateral femoral condyle measuring 2.9 × 1.3 × 0.5 cm, with displaced osteochondral fragment in suprapatellar recess. FINAL WORKING DIAGNOSIS: Femoral condyle osteochondral fracture due to subluxed patella TREATMENT AND OUTCOMES: - instructed to continue in knee bracing and non-weight bearing immediate consultation with orthopedic surgeon Underwent retrieval and open reduction internal fixation of osteochondral fracture fragment of lateral femoral condyle as well as cartilage harvest for possible future carticel procedure if the internal fixation were to fail did well post-operatively and progressed to weight-bearing 3 months post-operatively underwent chondroplasty and removal of retained screws" @default.
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• W2073904058 date "2009-05-01" @default.
• W2073904058 modified "2023-09-24" @default.
• W2073904058 title "Knee Injury - Mild Trauma" @default.
• W2073904058 doi "https://doi.org/10.1249/01.mss.0000354046.72845.37" @default.
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