Skip to content
Research Article Open access CC BY 3.0

An Unusual Source of Knee Pain in a Competitive Breaststroke Swimmer

Douglas W. Kelly

Journal of Scientific Research and Reports · pp. 2916–2922 · Published 16 Sep 2014

10.9734/JSRR/2014/12195

Abstract

Aims: The purpose of this case report is to present an unusual source of knee pain in a competitive breaststroke swimmer and review the clinical, etiologic, and radiographic features of the disease process. Presentation of Case: A 20-year-old collegiate swimmer presented with complaints of left knee pain and weakness. Physical findings of tenderness in a lateral condylar location, measurable thigh atrophy, and pain on a resisted knee extension test were present. Plain radiographs demonstrated osteochondritis dissecans of the lateral femoral trochlear groove and evidence of moderate trochlear dysplasia. Surgical findings confirmed a 3 cm by 1 cm loose osteochondritis dissecans fragment. Discussion: The knee is forcefully extended against the resistance of the water during the propulsive phase of the whip kick used by breaststroke swimmers. This movement results in high lateral patellofemoral contact loads and increased lateral patellar displacement forces. In a knee with trochlear dysplasia there are additional increases in patellar displacement and contact pressures. Osteochondritis dissecans involving the lateral trochlear groove has been associated with repetitive tangential type shear stresses. Conclusion: The findings in the present case report would suggest a very unique situation in which high lateral trochlear shear stresses were created by the repetitive whip kick activity in the knee of a breaststroker swimmer and that these unusual stresses were further magnified by underlying trochlear dysplasia. With continued intense training efforts, the shear stresses eventually exceeded a critical threshold of the subchondral bone of this region and failure occurred, resulting in osteochondritis dissecans of the lateral trochlea.

Breaststroker’s knee trochlear dysplasia osteochondritis dissecans whip kick

References (21)

  1. 1 Factors of patellar instability: An anatomic radiographic study [DOI]
  2. 2 Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. [DOI]
  3. 3 Anatomy and biomechanics of the medial patellofemoral ligament [DOI]
  4. 4 Chondromalacia Patellae. A prospective study [DOI]
  5. 5 OSTEOCHONDRITIS DISSECANS OF THE KNEE [DOI]
  6. 6 Management of Osteochondritis Dissecans of the Knee [DOI]
  7. 7 Osteochondritis Dissecans of the Knee: Treatment of Juvenile and Adult Forms [DOI]
  8. 8 Q‐angle influences tibiofemoral and patellofemoral kinematics [DOI]
  9. 9 The sulcus angle and malalignment of the extensor mechanism of the knee [DOI]
  10. 10 A Diagnostic Sign in Osteochondritis Dissecans of the Knee [DOI]
  11. 11 Analysis of the Patellofemoral Region on MRI: Association of Abnormal Trochlear Morphology With Severe Cartilage Defects [DOI]
  12. 12 Osteochondritis Dissecans of the Patellofemoral Joint [DOI]
  13. 13 Frequency, associated factors, and treatment of breaststroker's knee in competitive swimmers [DOI]
  14. 14 Breaststroker's knee: pathology, etiology, and treatment [DOI]
  15. 15 MRI of the knee in asymptomatic adolescent swimmers: a controlled study [DOI]
  16. 16 Breaststroker's knee [DOI]
  17. 17 Osteochondritis dissecans of the trochlea of the femur [DOI]
  18. 18 Breaststroke swimmer's knee [DOI]
  19. 19 MR Imaging Features of Osteochondritis Dissecans of the Femoral Sulcus [DOI]
  20. 20 Magnetic resonance imaging in the evaluation of osteochondritis dissecans of the patella [DOI]
  21. 21 Osteochondritis dissecans of the patellofemoral groove in athletes: unusual cases of patellofemoral pain [DOI]

Cited by 0

No indexed citations yet.

Article metrics

Real usage data collected on this platform.

29

Page views

0

PDF downloads

17

Outbound clicks

0

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.