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Sports and Soft tissue Knee Injuries

Sports and Soft tissue Knee Injuries. Neil Davies West Herts Hospitals Trust 21 st March 2007. Cover Briefly. Anterior Cruciate ligament injuries Meniscal tears in the young Cartilage lesions. ACL. Increasing frequency Predominant non contact situations

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Sports and Soft tissue Knee Injuries

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  1. Sports and Soft tissue Knee Injuries Neil Davies West Herts Hospitals Trust 21st March 2007

  2. Cover Briefly • Anterior Cruciate ligament injuries • Meniscal tears in the young • Cartilage lesions

  3. ACL • Increasing frequency • Predominant non contact situations • Netball/Football/Basketball/Skiing • Women > Men • History – no confidence/feels like its giving way • Not returned to sport

  4. History • > 50% have associated meniscal injury • Lateral > Medial • Audible “pop” in knee • Haemarthrosis – soon

  5. Examination • Subtle signs • Best done early or after a few weeks • Anterior draw • Lachman • Pivot shift

  6. ACL Injury

  7. Treatment • Non operative – proprioception work/physio rehab • Limited role for bracing • Operative – Bone Patellar Bone (BTB) Hamstring (4 strand) Synthetic

  8. ACL Grafts

  9. Results • 88-95% knees stable at 3-5 years • 80-92% return to sports at 3-5 years • 10-40% anterior knee pain with BTB • 10% hamstring deficits with HT • 6% anterior knee pain with HT

  10. Meniscal Tears • Common • Usually 20-45 age • Increasingly seen in 12-18 years • Different presentations • Different anatomy • Bucket handle can be minimally symptomatic

  11. Pathology

  12. Meniscal Repair

  13. Autologous Chondrocyte Implantation • Articular cartilage grafting • Best for smaller defects (2-10 cms) • 80% cover with articular cartilage • NICE approved • Still in infancy

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