Patella Dislocation Cont

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EXERCISE PRESCRIPTION Cycling and swimming are good alternatives to keep up general fitness. Valgus stress to the knee should be avoided so breast stroke is not recommended. EVALUATION OF TREATMENT OUTCOMES Monitor clinical symptoms and signs. Different functional knee scores for different sports are available to measure when the knee allows a return to full sport.

DIFFERENTIAL DIAGNOSES This is a straightforward diagnosis but associated injuries to the menisci, cartilage or cruciate ligaments should always be borne in mind.

PROGNOSIS Good-Fair. Appropriate treatment will allow a return to professional sports within three (non-operative) to six months (after surgery).

Fig. 132 Anatomic view of patella tendon rupture

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Fig. 132 Anatomic view of patella tendon rupture

Fig. 133 Clinical view of patella tendon rupture

SYMPTOMS Acute sharp pain to the anterior part of the knee and inability to walk and extend the knee. Patella tendon ruptures are rare. AETIOLOGY This is an injury that typically occurs after previous cortisone injections to the area or when using anabolic steroids, which weaken the tendon. Long-term use of corticosteroids in rheumatic or other systemic ailments are also common backgrounds.

CLINICAL FINDINGS Inability to elicit force on knee extension. There is a palpable gap in the patella tendon, swelling and bruising and haemarthrosis.

INVESTIGATIONS Clinical examination is the most important tool for diagnosis and should include tests for all ligaments and other structures in the knee. MRI or ultrasound can verify the tear.

TREATMENT An athlete with suspected patella tendon tear should be seen by an orthopaedic surgeon for surgery.

REFERRALS Refer to orthopaedic surgeon for further investigations to verify the extent of the injury. Physiotherapists will be involved in close collaboration with the surgeon. EXERCISE PRESCRIPTION After surgery, a braces is applied. After wound healing, cycling and swimming are good alternatives to keep up general fitness. Rehabilitation back to full sport usually takes around six months. EVALUATION OF TREATMENT OUTCOMES Monitor clinical symptoms and signs. Different functional knee scores for different sports are available to measure when the knee allows a return to full sport.

DIFFERENTIAL DIAGNOSES This is a straightforward but rare diagnosis. Because of haemarthrosis and give-way, it is sometimes mistaken for multiligament injury.

PROGNOSIS Good-Fair. The risk of re-rupture is very low but the long convalescence may sideline profesional athletes.

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