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Bruce, How are things?? You still in the USA or else where now?? How accurate do you think the patient's localization of pain is? **I would think it is pretty accurate. Is there pain with stairs/squats? **Yes How long ago was the surgery? **9/12 Did it decrease pain? **Not really, but I think my approach was to analyse the pain and focus more on function and returning to netball ASAP Why did she get the surgery? recurrent lateral dislocation? locking? **She had patella fracture (transverse) that was undetected. She had surgery because the doctor believes her patella position was more lateral than what it should be. What's her history? when did it start? what irritated it etc. An orthopod I work with believes many female adolescent dislocations are due to patella alta or a shallow intercondylar notch moreso than any muscle imbalance. I place importance on stretching all quads to inhibit any contribution they make to patella alta. Can you reproduce the medial pain with: Palpation/firm pressure on cartilage of medial condyle **Yes McMurray's **Yes PFJ lateral glide pressure in neutral , 45, & 90 degrees PFJ lateral compression/distraction/clockwise/anticlockwise rotation **NO Can you reproduce the locking? **Yes, just through passive flex and ext of the knee through range. Rx Try taping the knee with lateral displacement to ease medial PFJ surface friction, or tape medially to ease PFJ capsule strain. If this helps --> Continue taping for 3 weeks. Encourage patient application of heat at home 5x per day for 20 mins. Decrease knee use to help settle any chronic irritation. Ice when painful for 20mins on 20 off to decrease inflamm. ***Thanks Bruce, I will definitely try this when she comes in this weekend. Henry*** _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp