Robert F. LaPrade, MD, PhD

A 28-year-old male soccer player presented with acute onset of left knee pain and swelling following an awkward twisting motion during a game.

A 45-year-old man presented with a 6-month history of posteromedial right knee pain and swelling after a twisting injury to his knee in the gym.

A 24-year-old male professional soccer player sustained an acute twisting injury during match play. He presented 1 week later and reported having acute right knee swelling and the inability to bear weight on his right lower extremity.

An estimated 27 million U.S. youths participate in team sports and approximately 60 million youths participate in some type of organized athletics.

The management of patellofemoral instability can be complicated due to the multifactorial nature of this condition.

An otherwise healthy 16-year-old high school football player presented to the clinic with right knee pain following a blow to the anteromedial side of the knee in a football game. He could walk off the field and in clinic did not have significant pain, but his knee was stiff and swollen. The patient had a history of ACL reconstruction, which was performed twice on the affected right knee. The primary reconstruction was with an ipsilateral hamstring tendon autograft and the revision surgery was with the contralateral hamstring autograft. At the time of both ACL surgeries, the patient’s meniscus was normal with no evidence of tears and did not require treatment. However, the patient’s initial ACL reconstruction failed after 4 months following a non-contact twisting injury sustained during physical therapy.

Medial and lateral menisci are crescent-shaped fibrocartilage structures that provide joint congruity, stabilization and lubrication and act as “shock absorbers” for joint preservation. During weight-bearing activities, the menisci dissipate axial loads and contain hoop stresses. The medial meniscus transmits approximately 50% of the total joint load of the knee medial compartment, thus protecting the articular cartilage from excessive force.

A 56-year-old male, elite USA Masters track and field athlete presented to clinic 2 months after he experienced sudden onset posterior left knee pain while settling into a start from a starting block during a training session. After the injury, the patient tried running off the pain without relief. During the following weeks, he started walking with an antalgic limp due to increasingly severe pain localized to the anteromedial aspect of his left knee.