A patient presents to the Emergency Department after sustaining a twisting knee injury while skiing. She felt a pop and was unable to bear weight afterward secondary to pain and a feeling of instability. Shortly after the injury, she noted increased swelling and pain. On examination, she has a moderate effusion and a positive Lachman test. An x-ray was obtained and is shown above (Image 1. Case courtesy of Mikael Häggström, M.D. – Author info – Reusing images, CC0, via Wikimedia Commons).
Resources & References:
Don’t forget to review your 2-minute knee exam and brush up on Can’t Miss Adult Knee Injuries.
- Anterior Cruciate Ligament (ACL) Injuries. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases–conditions/anterior-cruciate-ligament-acl-injuries/
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- Posch, M., Schranz, A., Lener, M. et al. In recreational alpine skiing, the ACL is predominantly injured in all knee injuries needing hospitalization. Knee Surg Sports Traumatol Arthrosc (2020). PMID: 32803275.
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- Biscarini A, Contemori S, Busti D, Botti FM, Pettorossi VE. Knee flexion with quadriceps cocontraction: A new therapeutic exercise for the early stage of ACL rehabilitation. J Biomech. 2016 Dec 8;49(16):3855-3860. PMID: 28573973.
- Kilroe SP, Fulford J, Jackman SR, Van Loon LJC, Wall BT. Temporal Muscle-Specific Disuse Atrophy during One Week of Leg Immobilization. Medicine & Science in Sports & Exercise (2019). PMID: 31688656.
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- Seidenberg PH, Beutler AI. The Sports Medicine Resource Manual. Saunders Elsevier, 2008. P. 488.
- Dolbec KWD. Winter Wipeout: Skiing and Snowboarding Injuries. Critical Decisions in Emergency Medicine. January 2019; 33(1): p. 20.
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