KNEE INJURY - ALPINE SKING

Abstract

HISTORY - A 29 year-old world cup skier sustained a knee injury while steering a giant slalom turn. He unintentionally used his usual ski technique, when he got a bump on his right knee. He felt a short but very severe pain and he fell down in a big crash. After the crash he could not lift his leg and he had a lot of pain but there was no numbness. He was not able to stand up. The trainer beside the course made a radio call to the team doctor. PHYSICAL EXAMINATION - Examination of athletic in ski wear on the sideline of the race course was done. It was not practicable to come to a final diagnosis under these conditions. A knee immobiliser and ice were applied and the ski racer was brought to the ambulance by the mountain rescue team and later to hospital. DIFFERENTIAL DIAGNOSIS distorsion of the knee ACL rupture with meniscus lesion rupture of the patellar tendon TEST AND RESULTS: EMERGENCY ROOM RADIOGRAPHS Knee joint anterior posterior and lateral. No osseous lesions. MRI shows a rupture of the patellar tendon, no lesions of the ACL, PCL, menisci and other soft tissues of the knee FINAL WORKING DIAGNOSIS: Total rupture of the patellar tendon TREATMENT AND REHABILITATION surgery with metal-loop fixation and knee-device fixed in 5° flexion for 5 weeks 10 days after surgery beginning of the underwater therapy-passive mobilisation between 5° and 10° electro stimulation manual techniques for patella-mobilisation 6 weeks after surgery gait training with special devices, therab and-exercises, isokinetics in closed chain modus 2 months after surgery enforcement of strengthening and stretching techniques proprioceptive training, gait analysis and video analysis - walking with poles increasing of intensity and endurance return to ski races 8 months after injury