What do you get in response to these tests Henry?
How accurate do you think the patient's localization of pain is?
Is there pain with stairs/squats?
How long ago was the surgery?
Did it decrease pain?
Why did she get the surgery? recurrent lateral dislocation? locking?
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
PFJ lateral glide pressure in neutral , 45, & 90 degrees
PFJ lateral compression/distraction/clockwise/anticlockwise rotation
Can you reproduce the locking?
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.