Knee Injury-Weight Lifting

Abstract

1265 HISTORY: A 25 years old male competitive Olympic weight lifter presented for evaluation after injuring his right knee acutely when arising from a squat during a weight lifting competition. The athlete felt the knee give way and was unable to compete after the injury. He developed pain, swelling, and limited range of motion shortly after his injury. His past history was significant for bilateral Quadriceps Tendinitis treated with injections and physical therapy, but no previous history of acute injury. PHYSICAL EXAMINATION: Initial examination revealed swelling of the right knee with pain when attempting to flex the knee. He had tenderness to palpation over the medial joint line, and no patellar tenderness or apprehension. He exhibited a positive Lachman's test and no collateral ligament instability. Follow up examination after two weeks of physical therapy also revealed a Lateral Pivot Shift test. His collateral ligaments tests were normal. DIFFERENTIAL DIAGNOSIS: Anterior Cruciate Ligament Tear Meniscal Tear Patellar Tendon Rupture Patellar Dislocation Intra-articular Fracture TEST AND RESULTS: Right Knee X-Rays – No evidence of fracture or dislocation Right Knee MRI – Joint effusion, torn Anterior Cruciate Ligament, proximal Tibial bone contusion, Medial Meniscus posterior horn tear FINAL/WORKING DIAGNOSIS: Acute Anterior Cruciate Ligament Tear Tibial Bone Contusion Medial Meniscal Tear TREATMENT AND OUTCOMES: Physical Therapy to achieve full range of motion and reduce swelling prior to surgery Anterior Cruciate Ligament reconstruction with bone-patellar tendon-bone graft Post operative rehabilitation with early weight bearing, range of motion, closed kinetic chain exercises, bycicle, and propioceptive retraining Excellent results post reconstruction with full motion (6) six weeks after surgery, good strength, and stable knee post operatively Return to light training (3) months after surgery initially working in sports specific technique Training with 75 % of maximum lifting 6–7 months after surgery