meniscus. Second meniscectomy of the lateral meniscus was then performed, followed by standard physical therapy and returned to sport 3 months after surgery. After a full season, athlete now presents with persistent, residual anterolateral knee pain, and intermittent effusion after trainings. PHYSICAL EXAMINATION: 1. Full ROM 2. Flow test: negative 3. Strength test: Flexion and extension 5/5 4. McMurray/Apley tests: negative. Thessaly test: positive. DIFFERENTIAL DIAGNOSIS: 1. Meniscal tear 2. Synovitis 3. Post-traumatic osteoarthritis TEST AND RESULTS: Right knee MRI: • Mild degenerative thinning of lateral tibiofemoral cartilage • Moderate joint swelling, compatible with a synovitis • Tibial plateau deep cartilage fissures and mild bone marrow edema, progression of chondropathy Knee kinesiography (3D knee dynamic functional gait assessment): • Stiff knee gait, a protective mechanism characterized by the knee locked in extension during loading and stance demonstrating loading /absorption dysfunction • Static valgus alignment increased dynamically during loading phase and maintained during stance phase of gait demonstrating increased load on lateral compartment FINAL WORKING DIAGNOSIS: 1. Mild osteoarthritis of the lateral compartment 2. Mild synovitis TREATMENT AND OUTCOMES: 1. Athlete was educated on his mechanical dysfunctions and given home-based targeted neuromuscular gait re-training exercises to: • Improve knee flexion and absorption • Address static and dynamic frontal plane valgus instabilities 2. RICE + Monovisc viscosupplementation and 2 corticosteroid injections At 1-year follow-up, athlete maintains play at professional level with minimal pain and effusion. All KOOS subscales significantly improved. Knee kinesiography exam reveals improved dynamic knee function: • Improved absorption strategy with more flexion movement during loading • Improved dynamic frontal plane alignment during gait.
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