Vascularity in ACL
Has almost no vascularity.
Therefore, has almost no healing potential.
Inflammation of the tendon
Need a biopsy to officially diagnose tendonitis
A "diseased" tendon
Widespread connective tissue. There is superficial fascia that is under the skin, as well as deep fascia that is dense connective tissue.
These are involved in compartment syndromes.
Patellofemoral Pain Syndrome
Most common "knee pain" presentation
Exact cause unknown
Acute Soft Tissue Injuries
These may damage arteries. If this is not detected, the extremity may become ischemic and may need amputation.
You NEED to do an anchiobrachail index on these patients. This is when you take the blood pressure above and below the site of injury. If it is less than 0.8, then they have an arterial injury and they may potentially need to go to amputation.
Muscle Contusion Hematoma
Basically a big bruise or crushing injury of the muscle tissue with bleeding may lead to a hematoma formation. This is usually from a direct blow, and the quadriceps are very common.
BEWARE NSAID history. This can cause uncontrolled bleeding.
Ossification that occurs in muscle tissue after moderate or severe contusion-hematoma.
Clinically, this presents as increasing pain and reduced ROM following a muscle contusion. Most often in the quadriceps or biceps.
Be aware of this, and check for it after 2-3 weeks.
Assess with VERPS
Can be contact or non-contact (more likely)
With contact, a player is usually hit in the anterior of their knee
With non-contact, it is often placing legs outside of shoulder-width
Used to assess ACL tears
V - valgus force
ER - external rotation
P - pop
S - swelling (immediate)
Reassess in 7-10 days
Treatment for ACL Tears
Non-surgical can include physiotherapy, bracing, and activity modification.
Surgical can include re-attachment. This is to restore stability as the primary goal as well as function. Pain comes secondary.
Most common mechanism of injury is a blow to the lateral knee with a valgus force, but may also be injured by non-contact and/or rotational forces. This can be falling on a flexed knee which drives the tibia posterior on the femur.
Most often treated non-operatively
Treatment for MCL Tears
Usually treated non-operatively.