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Selected Case Studies
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Lumbar Degenerative Disc Disease
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Low Back Pathology
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Dancer S/P Multiple Trauma
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Carpal Tunnel, Post Release
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Cervical Pathology
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Charo-Marie Tooth Disease
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Degenerative Medial Meniscus
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Femur Fracture - IM Rod
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Hip Pathology
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Knee Pathology
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Systemic Lupus Erythematosus
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Pitcher's Shoulder
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Rotator Cuff Pathology
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Shoulder Tendonitis
Functional Capacity Evaluations

CASE STUDIES - Knee Pathology

History: The patient is a 21 year old male wrestler. During a wrestling bout, while pinning his opponent with a "scissors" hold, he claimed to have "heard a popping noise and felt a pain in his right knee." The patient complained of medial/lateral joint pain. The condition did not improve. Over the course of 2 years, this patient was examined by 6 physicians [3 Orthopedic Surgeons]. Objective testing, including x-ray, MRI, and physical examination, failed to provide objective evidence of pathology. Therefore, no further treatment was implemented.

Test Protocol: A test was designed to analyze the kinematics, kinetics and functional electromyography of the patient's hips, knees and ankles. Video computerized motion analysis, walking track force platform system and multi-channel dynamic surface electromyography pre-amplified electrodes were utilized to gather the necessary data.

Kinematic analysis revealed an abnormality in the distribution of vertical force loading, during the weight-bearing phase of the right knee. Note the mid-stance drop [Graph I]. [Graph II] shows a deficit of smooth medial/lateral force transition on the medial aspect of the left knee, as compared to the right.


Graph I
Vertical Loading - Right vs. Left Knee



Graph II
Vertical Loading - Right vs. Left Knee


This result was further confirmed with kinetic force platform analysis. Dynamometer strength testing confirmed weakness in the right hamstring muscle group [Chart I].



Chart I
Values of EMG and Dynamometer Testing


Outcome: The functional motion analysis test results gave the surgeon objective evidence and indication to proceed with arthroscopic surgery. During surgery of the right knee, the surgeon discovered a small tear in the region of the posterior horn of the medial meniscus (corresponding to Graph II). The free fragments were removed. Post arthroscopic surgery, the patient was referred to physical therapy for four weeks. The patient reached his strength and functional plateau and is back to unlimited work and sports activities.



© 2008 Kinematic Consultants, Inc.