Knee Injury Essay

1455 words - 6 pages

A Spill at Parsenn Bowl:
Knee Injury and Recovery
by

Elaine S. Chapman
Department of Biology
Illinois College, Jacksonville, IL

Part I – The Slopes
Elaine was enjoying a pleasant day on the ski slopes at Winter Park. When she got on the lift to the top
of Parsenn Bowl (, ft), the weather was fine—windy, but sunny. During the - or -minute ride,
the weather changed suddenly; it became a white-out, with icy surface snow, blowing snow, a very strong
wind, and extremely low visibility. Many people fell as they got off the lift, including Elaine. However, she
got up and joined her family members as they stood, wondering just how they were going to get ...view middle of the document...

He quickly removed her ski boots, checked the dorsalis pedis pulse, and told her to take off her parka; an
assistant brought blankets and hot chocolate. At that time Elaine was not experiencing intense pain, but she
was shivering uncontrollably. The pain was relatively localized to the medial surface of her right knee, and the
knee was already considerably swollen. He indicated that there was probably damage to a ligament or two.
Elaine was then moved to the Mile-High Clinic for further evaluation.

Questions
. Why was Elaine instructed to remove her parka?
. Why was she shivering?
. Why was the knee swollen?
. Where would the dorsalis pedis pulse be taken? Why?
. How do the bones that comprise the knee joint fit together?
. What structures are associated with the medial surface of the knee?

“A Spill at Parsenn Bowl” by Elaine S. Chapman

Page 

Part III –The Mile-High Clinic
In the clinic, Elaine was examined by a nurse practitioner and sent for an X-ray, which showed swelling but
no fracture. The nurse practitioner performed a Lachman test on Elaine’s knee; the results were so positive
that they could be seen across the room. In fact, an orthopedic surgery resident was brought in so that he
could feel and see rsthand the contrast between a positive Lachman test (on her right knee) and a negative
test (on the left, uninjured knee). A positive Lachman is essentially diagnostic of complete rupture of the
anterior cruciate ligament (ACL). Further examination conrmed injury to the medial collateral ligament.
Elaine was instructed to see an orthopedist at home and given crutches and a brace as well as some pain
medication because her knee was not stable enough to walk and was beginning to hurt. In addition, she was
told to keep her leg elevated and put ice on her knee—and definitely not use the hot tub.

Questions
. What type of injuries would be identified most clearly on an X-Ray? Why?
. What is a positive Lachman maneuver/test?
. What is the purpose of the leg elevation and ice? (Wasn’t she already high enough and cold enough?)
. Why was she instructed not to use the hot tub?

“A Spill at Parsenn Bowl” by Elaine S. Chapman

Page 

Part IV –Seeing the Orthopedic Surgeon \#1
The day after she arrived home, Elaine saw Dr. Scott. He ordered an MRI, which conrmed the injury. He
suggested that she consider reconstructive surgery on her knee. While some patients elect to avoid surgery,
they are at much higher risk of developing osteoarthritis earlier, and the instability of their knee makes them
more likely to fall again. Thirty years ago most surgeons would not have suggested surgery for this injury,
particularly in someone aged , and the surgical techniques were not as successful as they are now. Because
Elaine was a fairly active individual prior to the accident, Dr. Scott encouraged her to have reconstruction of
the anterior...

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