Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 25049
  Title Conservative management of possible meniscal derangement using the Mulligan concept: A case report
Journal J Chiropr Med. 2017 Dec;16(4):308-315
Peer Review Yes
Publication Type Case Report

Objective: The purpose of this case study was to report on the immediate effects of the combined use of mobilizations with movement and the “squeeze” technique on a patient with knee stiffness, popping, and swelling.

Clinical Features: The patient presented with right knee stiffness, swelling, and a popping sensation of insidious onset. Clinical examination revealed pain with terminal knee extension and flexion, joint line tenderness, a positive Apley’s compression test, and a positive Thessaly’s test at 20° of knee flexion. A working diagnosis was established of a meniscal pathology with the differential diagnoses of meniscal derangement and synovial plica.

Intervention and Outcome: The patient received 3 total treatments using the Mulligan concept over the course of 11 days. The treatments included the application of a tibia internal rotation mobilization with movement and the “squeeze” technique to the affected knee. Patient outcomes, including the Disablement in the Physically Active Scale, the Patient-Specific Functional Scale, and the Numeric Rating Scale for pain, were collected throughout the course of treatment. The patient reported a minimal clinically important difference on the Numeric Rating Scale for pain after each treatment and on all outcomes after the third treatment. The patient reported improvement on her follow-up visit 4 days after the third treatment; the results of a clinical exam and patient outcomes supported a complete discharge after 3 treatments.

Conclusion: This patient responded favorably to use of the Mulligan concept as a manual therapy technique for the treatment of symptoms related to possible meniscal derangement.

Author keywords: Musculoskeletal Manipulations; Knee Injuries; Osteoarthritis

Author affiliations: University of Idaho. WWAMI Medical Education Program (United States / Idaho / Moscow); University of Idaho. Department of Movement Sciences 

This abstract is reproduced with the permission of the publisher; full text is available by subscription.


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