Disclosures: Joseph Zeni, Jr., PT, PhD: Emovi, Inc (Products/Services: Yes) (Consultant/Advisory Board)

Case Description: The patient was injured during a tackle, which resulted in a medial collateral ligament sprain. He returned to play after four weeks, but had continued knee pain. He subsequently suffered a fibular fracture during gameplay. He was cleared to return to play after surgery and physical therapy, but he continued to have knee pain for the following year, despite rehabilitation and an orthotic for overpronation. His musculoskeletal examination revealed no strength or motion deficits at the knee.

Setting: Sports training clinic

Patient: A 26-year-old professional American football player with chronic knee pain Assessment/

Results: To explore mechanical causes of knee pain, the patient underwent a three dimensional biomechanical knee examination (Knee Kinesiography, KneeKGTM, Emovi, Inc.) This is an FDA cleared device that consists of an infrared camera, a thigh and shank marker attached to an exoskeleton that limits motion artifact, and a laptop computer. A report of kinematic variables is auto-generated at the end of two 45-second treadmill walking trials. His analysis revealed several biomechanical abnormalities: 1) delayed knee flexion with excessive tibial movement, 2) excessive varus alignment (4.6⁰), and 3) tibial internal rotation collapse (5⁰). The assessment also revealed that his orthotics increased his dynamic varus and failed to correct his internal tibial collapse. He was prescribed 4 corrective exercises and a modification to his orthotic. The patient was able to return to play without pain after one month of targeted training, and after 4 months he reported feeling at peak career performance.

Discussion: This patient benefited from a Knee Kinesiography exam to identify biomechanical abnormalities that contributed his pain and sub-optimal knee performance. This assessment can be integrated into rehabilitation management to improve short and long-term patient outcomes.

Conclusion: In the presence of chronic knee pain that does not respond to traditional therapies, biomechanical assessment and treatment may be warranted.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-use-of-knee-kinesiography-in-the-sports-rehabilitation-of-chronic-knee-pain-a-case-report/