Good morning from Germany to everybody.

I have a patient, female, 32, Sports: Dancing Latin, gym; Officejob, pretty slender. About a year ago she went mountainhiking, about 6 hrs, downwards jumping with backpack over the meadow, downhill. Day after Kneeswelling left leg - Pain!Long journey of Diagnosis started until finally Wikipedia reference-linkMRI stated:heavy Bonebruise medial Femurcondylus, no "infraktion" intacte peripheral cortical structures.
Further Femuro-Tibial Chondromalacie Grade 3
Patella structure Wiberg 2 with Chondromalcia patellae Grade 3
no visual degeneration of menisci
small edema
Baker csyt 5*2,5 cm - Patient is about 155cm
Lig. all intact
was treated with physio no change - Arthroscopy, shaving, lavage, microfracturing - thereafter immobilistaion, crutches 0-load für 6 weeks, no physio. On Christmas 09 15° of extension deficite, constant medial kneepain.
Physio with Physical training legpress etc. no change!
Since the mid of Jan, the patient is with me,
P/E the patient has no control or possibility of Muscular stabilisation of the Joint, she has been training in a legpress without even having conrol over the joint, both of her Quads are totally atropied, she feels constant Pain at the Muscle/tendinous inbterface of the M.Vast. med., EOR in Ext. she feels "her" Pain left leg.
I'having her do Isometric exercises with moderate extension -
Easy PNF patterns without resistance
as well as I#m trying to build up some strength in her popliteus and Hamstrings - Musculuare endurance for the beginning.

Could anybody help here?
I'd like to get more to the core oft the problem

Thank you everybody

Similar Threads: