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Anterior Knee Impingement in a High-Level Football Punter: A Case Report and Description of the Active–Passive Knee Extension Test

Sommerfeldt, Mark F. MD, FRCSC*; Kaeding, Christopher C. MD

Clinical Journal of Sport Medicine: November 2017 - Volume 27 - Issue 6 - p e75–e77
doi: 10.1097/JSM.0000000000000394
Case Report

Abstract: A 22-year-old football punter complained of anterior knee pain deep to his patellar tendon that occurred every time the knee of his kicking leg reached full extension during a punt. Arthroscopy confirmed anterior impingement between a fibrous tissue eminence directly anterior to his anterior cruciate ligament (ACL) and the intercondylar roof in full extension. With the eminence removed, full extension no longer caused impingement as demonstrated arthroscopically. He resumed punting at maximal effort 6 weeks postoperatively without pain. We report the active–passive knee extension test, a physical examination maneuver designed to identify patients with anterior knee impingement between tissue anterior to the ACL and the intercondylar roof. This test is a helpful part of the clinical examination in detecting these lesions.

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*Division of Orthopaedic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; and

OSU Sports Medicine Center, The Ohio State University, Columbus, Ohio.

Corresponding Author: Christopher C. Kaeding, MD, OSU Sports Medicine, The Ohio State University, Suite 3100, 2050 Kenny Rd, Columbus, OH 43221 (

The authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received February 08, 2016

Accepted August 03, 2016

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