Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute left knee injury following a high-energy valgus stress mechanism with rotational force. Reports immediate "pop," severe pain, and rapid onset of hemarthrosis. Patient describes a sensation of knee instability, locking, and inability to bear weight.
Clinical Examination Findings
Left knee examination reveals significant joint effusion. Palpation demonstrates localized tenderness along the medial joint line and medial collateral ligament (MCL). Lachman test and anterior drawer test are positive, indicating ACL deficiency. Valgus stress test at 0 and 30 degrees reveals increased laxity and pain. McMurray test is positive for medial meniscus pathology. Range of motion is limited by pain and mechanical block. Neurovascular status is intact distally.
Treatment Protocol
Immediate management includes RICE protocol (Rest, Ice, Compression, Elevation) and immobilization with a hinged knee brace. Analgesia initiated with NSAIDs. Patient referred for urgent MRI of the left knee to confirm extent of ligamentous and meniscal injury. Surgical consultation for arthroscopic reconstruction of ACL and repair/debridement of meniscus and MCL stabilization is planned.