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Functional capacity - knee pathology

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 evidence of true pathology; therefore, no further treatment was implemented. The last Orthopedic Surgeon to examine the patient ordered a Functional Gait and Motion Analysis Study. [see Illustration I]

Knee Illustration

Illustration I
Side View - Gait Kinematics

Test Protocol

A test was designed to analyze the kinematics, kinetics and functional electromyography of the patient's bilateral hips, knees and ankles. Video computerized motion analysis, walking track force platform system and multi-channel dynamic electromyography procedures were implemented to gather the necessary data.

Functional Motion Analysis Results

Kinematic analysis revealed an abnormality in the distribution of vertical force loading, right knee, during the weight-bearing phase [see Graph I]. This graph shows a distinct vertical pressure abnormality pattern for the right knee. Note the mid-stance drop and increase of pressure. Further analysis shows the loading abnormality to be specifically centered in the medial-posterior aspect of the right knee [see Graph II].


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. EMG and dynamometer strength testing confirmed weakness in the right hamstring muscle group.


The functional motion analysis test results gave the surgeon objective evidence and justification 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. The free fragments were removed. Post Arthroscopic surgery, the patient was referred to physical therapy for 4 weeks. The patient reached his strength and functional plateau and is back to unlimited functional activities, including sports.

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