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Author Topic: Thoughts on What Injury Might Be  (Read 890 times)

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Offline stellanora

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Thoughts on What Injury Might Be
« on: August 03, 2010, 11:00:49 PM »
My son and I are anxiously awaiting the results of his MRI. In the meantime I am posting his injury/symptoms here to see what people think might be wrong. First some history on my poor boy and his knees...

In 2006 my son tore his right acl in a collision/hyperextension injury while playing soccer. He heard/felt a loud pop and his knee swelled right away. He could not walk without his knee bent for a few days. He was 14 at the time. He had a hamstring autograft and recovered without incident and was back playing soccer in 5 months.

In 2009 he tore his left acl in a very benign  looking incident. He was surrounded by a group of players and after he broke free and kicked the ball, he landed a bit awkwardly and went right down. The swelling was much less noticeable than the first time and he did not feel a pop....or at least doesn't think he did. He did feel a crunch and had lateral knee pain. He was able to walk off the field and limped around for two or three days then regained his normal gait pretty quickly. He felt like his knee was "going backwards" whenever he walked downstairs. He again had a hamstring autograft and was back playing full steam at 6-7 months.  When he was just returning, in the 6th month, he reported feeling a pop in his RIGHT (initial ACL injury) knee. Not loud....just a small popping sensation. He was able to keep practicing. His only complaing initially was some medial discomfort. He asked to go to the ortho because his knee did feel tight inside a couple of days after that. An MRI was done and it showed a small joint effusion but no evidence of other injury.  Our ortho was unsure whether this was scar tissue or maybe even a small tear that did not show up on the MRI. About 5 weeks later my son was at a college showcase camp and he took a shot on goal. He said it was a little kick and when he landed he felt a crunching sensation in the medial area of his knee and he went down because of the pain. This time, unlike the previous two times, he had to use crutches because weight bearing was painful.  The trainer said that there was a ismall amount of swelling medially 1 1/2 hours after the injury. She felt Lachman's and Anterior Draw exams were comparable to his left leg.  I picked him up the next day and his knee was swollen medially. By the next day though his knee was much more swollen. He at first saw the PA (ortho on vacation) who thought this was an MCL sprain. When we saw the ortho a few days later, he felt it was more likely a meniscal or even a chondral injury. He has medial midline pain which in the first few days was especially bad at night as it hurt to change position in bed. The medial pain was also exacerbated when getting out of the car. Stairs seems to cause some discomfort as well. It has now been two weeks since the injury and his gait is normal but there is still a small amount of swelling visiible and he is knee still feels tight inside and he can't get flexion much past 90 or 100 degrees. No locking, but he did have difficulty with full extension just one time. No feeling of instability.

So....any verdicts/opinions out there while we await our results? This is horrible timing. He is a rising senior and was still being looked at by schools. He has an official visit set up for the fall. Now he is thinking he might have to do a post grad year if it is another ACL. Any input???

Offline Snowy

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Re: Thoughts on What Injury Might Be
« Reply #1 on: August 04, 2010, 05:54:52 AM »
I'm not an expert by any means, but given the manual test results and the fact that he has no instability it sounds like a meniscus tear is a strong possibility. If this is the case, it will probably need surgery - but the recovery time for a meniscus repair is much, much faster than the lengthy rehab from an ACL reconstruction. Hopefully it's not a chondral injury - while there are more repair options for these available all the time as research and techniques improve, it's a much longer and tougher road back.

I'm assuming you guys are having (or have had) an MRI done?

On a tangent, the poor guy having two ACL ruptures! I'm just recovering from my first reconstruction and going through it once is bad enough. But these are the sacrifices we make for the sports we love. :)

Best of luck to your son - I hope his latest injury turns out to be a straightforward fix.

Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline stellanora

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Re: Thoughts on What Injury Might Be
« Reply #2 on: August 05, 2010, 06:25:39 AM »
Is a large amount of swelling generally seen with a medial meniscus tear? Most of the swelling visible on the outside is/was in the area above and medially to his knee. Today he was getting up from a low seat and when he put weight on that let as he was turning he had a very sharp pain in the medial knee. Still no MRI result.

Offline Snowy

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Re: Thoughts on What Injury Might Be
« Reply #3 on: August 06, 2010, 12:48:51 AM »
I think swelling is a pretty typical symptom of meniscus tears. Here's some more info from a general article on the topic:

"Individuals who experience a meniscus tear usually experience pain and swelling as their primary symptoms. Another common complaint is joint locking, or the inability to completely straighten the joint. This is due to a piece of the torn cartilage physically impinging the joint mechanism of the knee. The most common symptoms of a meniscus tear are:

Knee pain
Swelling of the knee
Tenderness when pressing on the meniscus
Popping or clicking within the knee
Limited motion of the knee joint"

]http://orthopedics.about.com/cs/meniscusinjuries1/a/meniscus.htm

The symptoms do also match the limited range of motion that you mention, too.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA