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Davis, R.

McElroy, M.

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Acute	  Patella	  Subluxation	  in	  Crossfit	  Athlete,	  Not	  So	  Fast	  Richard	  Davis	  DO,	  Geisinger	  Sports	  Medicine	  Sponsor:	  Matthew	  McElroy	  DO	  	  HISTORY:	  	  A	  30	  CRNA	  active	  crossfit	  athlete	  sustained	  a	  right	  knee	  twisting/patella	  subluxation	  when	  she	  was	  doing	  a	  clean	  and	  jerk	  at	  a	  crossfit	  gym.	  She	  felt	  as	  though	  her	  patella	  displaced	  laterally	  and	  then	  her	  knee	  gave	  out.	  Her	  patella	  spontaneously	  reduced	  after	  she	  extended	  her	  knee.	  She	  went	  to	  the	  community	  ED	  later	  that	  day	  where	  her	  x-­‐rays	  were	  negative;	  she	  was	  placed	  in	  a	  knee	  immobilizer	  and	  followed	  up	  with	  the	  sports	  medicine	  clinic	  2	  days	  later	  for	  follow-­‐up.	  	  PHYSICAL	  EXAMINATION:	  Right	  knee:	  TTP	  over	  suprapatellar	  region,	  2+effusion,	  3/5	  extension	  of	  right	  knee,	  ligamentous	  structures	  difficult	  to	  evaluate	  due	  to	  guarding.	  	  Pain	  with	  forced	  flexion,	  otherwise	  NVI	  distally,	  compartments	  soft.	  	  DIFFERENTIAL	  DIAGNOSIS:	  Patella	  instability,	  ACL	  tear,	  PCL	  tear,	  osteochondral	  defect,	  meniscal	  injury,	  quad	  tendon	  rupture,	  patella	  tendon	  rupture.	  	  TESTS	  AND	  RESULTS:	  X-­‐ray	  shows	  good	  maintenance	  of	  patellofemoral	  and	  tibiofemoral	  joint	  spaces.	  Decision	  to	  get	  MRI	  was	  made	  considering	  she	  had	  tense	  effusion	  and	  was	  a	  female	  of	  child	  bearing	  age.	  MRI	  shows	  torn	  ACL,	  tear	  of	  posterior	  horn	  of	  medial	  meniscus	  extending	  to	  superior	  articular	  surface,	  vertical	  tear	  of	  lateral	  meniscus	  extending	  to	  superior	  articular	  surface,	  13mm	  full-­‐thickness	  cartilage	  loss	  overlying	  medial	  femoral	  condyle,	  5mm	  region	  of	  full	  thickness	  cartilage	  loss	  overlying	  lateral	  femoral	  condyle.	  	  FINAL/WORKING	  DIAGNOSIS:	  	  ACL	  tear,	  medial	  and	  lateral	  meniscal	  tears	  with	  articular	  cartilage	  injury.	  	  TREATMENTS	  AND	  OUTCOMES:	  Evaluated	  by	  Orthopedic	  Sports	  Surgeon	  who	  decided	  on	  2	  weeks	  of	  rehab	  and	  she	  worked	  on	  maintaining	  range	  of	  motion	  and	  quadriceps	  strengthening.	  She	  then	  underwent	  successful	  surgery	  with	  ACL	  reconstruction,	  medial/posteromedial	  reconstruction,	  allograft	  for	  ACL	  reconstruction	  and	  microfracture	  of	  medial	  femoral	  condyle.	  	  

Acute Patella Subluxation in Crossfit Athlete

http://digitalcommons.wku.edu/cgi/viewcontent.cgi?article=2847&context=ijesab

Acute Patella Subluxation in Crossfit Athlete

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