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$40,000 Non-Pecuniary Assessment for Patellofemoral Knee Pain

Adding to this site’s archived posts addressing damages for knee injuries, reasons for judgement were released last week by the BC Supreme Court, Vancouver Registry, assessing damages for Patellofemoral pain.
In the recent case (Peragine v. Serena) the plaintiff was involved in a 2009 intersection collision.  The Defendant left a stop sign and proceeded into the Plaintiff’s lane of travel resulting in the collision. Although the Defendant disputed fault she was found fully liable for the crash.
The plaintiff suffered a knee injury which required surgery.  She remained symptomatic at the time of trial and was expected to have symptoms for some time into the future.  In assessing non-pecuniary damages at $40,000 Mr. Justice Weatherill provided the following reasons:

[70] Dr. Kokan concluded that Michelle’s pain in her left knee was and is caused by the medial synovial plica (which was removed during the surgery), patellofemoral pain syndrome and pes anserinus bursitis.  It is his opinion that the motor vehicle collision on March 13, 2009 caused the onset of her left knee pain, which irritated the medial synovial plica.  He acknowledges that there is controversy in the literature and within his profession regarding the function of the synovial plica and its contribution to symptoms.  Some orthopedic surgeons, including Dr. Kokan, are of the view that it can make one susceptible to pain.  Others are of the opinion that the plica has minimal, if any, impact on pain.  Dr. Kokan concluded that Michelle’s plica, which was in a vulnerable position, being suddenly impacted caused direct trauma and caused her to experience the pain she had reported.  Moreover, the blunt impact of the accident also transmitted forces to other structures within her knee, including the patellofemoral joint.

[71] Dr. Kokan also acknowledged that patellofemoral pain syndrome could be caused by a person being inactive and then suddenly becoming active.

[72] In Dr. Kokan’s opinion, it is likely that Michelle could continue to experience her pain symptoms for between two to three years.  He expects that she will continue to experience difficulties with kneeling, walking, standing and negotiating stairs.  He recommends that Michelle limit her sports to non-impact activities such as swimming or cycling…

[75] I accept Dr. Kokan’s description of Michelle’s symptoms as described in his report.  I also accept his opinion that the pain in her left knee was caused by a blunt impact during the March 13, 2009 collision and that it is possible for the injury to the knee to have occurred during the accident but the pain associated with that injury not to have manifested itself for three weeks to a month…

[118] All of the injuries Michelle suffered to her forehead, shoulder, neck and back were minor and completely resolved within a few weeks.  None have reoccurred, although she does have a small, residual but indiscreet scar on her forehead.

[119] However there is no question that, since the collision, Michelle has experienced and is continuing to experience intense and ongoing pain in her left knee.  She is unable to climb or descend stairs or even walk or stand for prolonged periods of time without significant pain and having to sit and rest her knee.  She is unable to participate in sporting activities which she has grown up doing and which are her passion…

[130] The plaintiff is 21 years of age.  She continues to have trouble walking and standing without pain.  She is in pain every day.  Despite the pain, she is living a normal and enjoyable life.  The prognosis for a full recovery is good.

[131] After reviewing the foregoing cases and taking my findings of fact in this case into account, I find that that an award of $40,000 for non-pecuniary damages is appropriate.

Mr. Justice Weatherill, patellofemoral injury