Fast Bowler's knee - anteromedial articular impingement.

Purpose: To describe a series of impingement lesions found on the anterior aspect of the medial femoral condyle in international cricketers.

Methods: Seven international level fast bowlers presented to our clinic with knee pain in the lead leg between 2005 and 2013. The mean age of the patients was 26.7 years (20-29 years). In all patients a careful history and examination was undertaken followed by appropriate investigations. Conservative management and arthroscopic surgery were performed on these cases. We aimed for a pain free quiet knee with resolved oedema on MRI and return to sport.

Results: MRI images showed oedema in the medial femoral condyle in all patients and 4 patients also had associated cartilage loss. These 4 patients underwent arthroscopic surgery whereas the other 3 were less symptomatic and were managed conservatively. All patients returned to international cricket at an average of 6 months in the non-operative group and 8 months in the operative group.

Conclusion: Anterior impingement of the anteromedial femoral condyle can be a potentially serious lesion in the fast bowler. A strong index of suspicion regarding this lesion has to be exercised when a fast bowler attends with knee pain and effusion.