Knee Injury - Soccer

Abstract

0627 HISTORY: 18 year old male freshman collegiate soccer player sustained a left knee injury during a game. The mechanism of injury was felt to be a hyperextension of the knee with a varus load. He continued to play in the game. He noted worsening pain throughout the next day and was seen in the training room. He complained of a giving out sensation in extension. He denied any locking or clicking. PHYSICAL EXAMINATION: Initial examination revealed no effusion, full active range of motion, no laxity to varus or valgus testing at 0 or 30 degrees, normal anterior drawer at 90, apparent increased anterior translation with a firm end point at 30 degrees, positive posterior drawer at 30 degrees, negative posterior drawer at 90 degrees, positive posterolateral joint line tenderness, negative McMurray's, positive recurvatum when toes are elevated off the table, positive recurvatum when standing, no tenderness over the fibular head, no tenderness over the femoral condyles or tibial plateau, and normal neurovascular exam. DIFFERENTIAL DIAGNOSIS: Posterior cruciate ligament injury Lateral meniscus injury Lateral collateral ligament sprain Hamstring strain Posterior lateral corner injury Anterior cruciate ligament injury Bone contusion TEST AND RESULTS: None Indicated FINAL/WORKING DIAGNOSIS: Isolated posterolateral corner injury TREATMENT AND OUTCOMES: Allowed to return to play as tolerated by pain Offered knee brace versus hyperextension taping and he elected to use taping as this felt more comfortable and allowed him a closer to normal activity level. His pain was tolerable for the remainder of the soccer season and he did not miss any games because of this injury.