Fast Bowler\u2019s knee \u2013 anteromedial articular impingement

Andy M Williams,Mary H Jones,Simon M Thompson,Michael J Reid,Avinash Alva,Ranju T Dhawan

doi:10.1186/s40634-020-00237-7

Abstract

PurposeTo describe a series of impingement lesions found on the anterior aspect of the medial femoral condyle in international cricketers.MethodsSeven international level fast bowlers presented to our clinic with knee pain in the lead leg between 2005 and 2013. The mean age of the patients was 26.7 years (20–29 years). In all patients a careful history and examination was undertaken followed by appropriate investigations. Conservative management and arthroscopic surgery were performed on these cases. We aimed for a pain free quiet knee with resolved oedema on MRI and return to sport.ResultsMRI images showed oedema in the medial femoral condyle in all patients and 4 patients also had associated cartilage loss. These 4 patients underwent arthroscopic surgery whereas the other 3 were less symptomatic and were managed conservatively. All patients returned to international cricket at an average of 6 months in the non-operative group and 8 months in the operative group.ConclusionAnterior impingement of the anteromedial femoral condyle can be a potentially serious lesion in the fast bowler. A strong index of suspicion regarding this lesion has to be exercised when a fast bowler attends with knee pain and effusion.

Highlights

The popularity of the game of cricket has increased since the introduction of limited over cricket (20 and 50 over format) and this has led to a significant expansion in the number of matches played, at international level [1]
Fast bowlers have been shown to have the greatest workload compared to other cricketers, covering between 20 and 80% more distance and this is 2–7 times more likely to be at a higher intensity [2]
We report on a series of seven elite level international fast bowlers who presented with a similar injury pattern to the anterior aspect of the medial femoral condyle of the knee

Summary

Methods

Seven international level fast bowlers presented to our clinic with knee pain in the lead leg between 2005 and 2013. The mean age of the patients was 26.7 years (20–29 years). In all patients a careful history and examination was undertaken followed by appropriate investigations. Conservative management and arthroscopic surgery were performed on these cases. We aimed for a pain free quiet knee with resolved oedema on MRI and return to sport

Results

Introduction

Conclusion