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Knee Conditions

Knee Joint Mechanics Occurs between the TIBIA and the FEMUR
Knee Joint Mechanics flexion and extension
Patellofemoral Joint Patella glides up and down in a Groove on the Femur
Knee Joint Muscles QUADS, HAMS, GASTROC, Others
Knee Ligaments ACL PCL MCL LCL
Collateral on one side
Cruciate To Cross
MCL Medial ( TIBIA ) Collateral Ligament - most injured. Attaches from Tibia to Femur. Prevents VALGUS ( knock knee ) stress. Broad Ligament.
LCL Lateral ( fibular ) Collateral Ligament. Attaches from Fibula to Femur. Prevents VARUS ( bow legged ) stress. Small, rounded lig.
ACL Anterior Cruciate Ligament. Named for it's attachment to tibia, Anterior Tibia to posterior femur. Prevents Anterior displacement of tibia on femur. Deep and not palpable.
PCL Posterior Cruciate Ligament. Attaches on Posterior tibia to anterior femur. Prevents posterior displacement of tibia on femur. Deep and not palpable.
Knee Cartilage There are 2 kinds, Articular or Hyaline and Meniscus.
Articular Cartilage On the ENDS of BONE. Provides for a smooth gliding motion.
MENISCUS Fibrocartilage - shock absorber.
MENISCUS Fibrocartilage - shock absorber. Not palpable. 2 semicircular parts - medial and lateral. Sits between the tibia and femur. Has a 1/3 peripheral RED ZONE - VASCULAR. Wedge shaped. Thicker peripherally
Patellorfemoral Joint Articulation between the Patella and Femur. Patella has a V shape posteriorly. Glides in groove on femur.
Knee Evalution History. History. History
Knee Evalution History - MOI, POPS - 1 ( 1- ligament, 2 - multiple ligs OR DISLOCATION in and out. Previous Injuries. Location of pain. Swelling ( when ? ), Stability or NOT. Shifting, REFLEX, WEAK.
Knee Observation Bilateral Comparison. SWELLING, discoloration, ATROPHY, deformity.
JOINT EFFUSION Swelling in joint capsule.
Palpation Feel for tenderness - Patellar TENDON. MCL / LCL. Joint line for meniscus. MILKING TEST for swelling.
RANGE OF MOTION Flexion and extension of knee.
Muscle Testing Resist Flexion for hams. Resist Extension for quads.
Muscle Testing Perform Bilaterally
Special Test Ligament Laxity - ACL - PCL - LCL - MCL. Meniscus Tests. Patellar Subluxation. Patellofemoral Dysfunction Test.
INJURIES Ligament Sprains - Grades 1-2-3. Patellar Tendinitis. Patella Subluxation or Dislocation. Chondromalacia Patella. Meniscus Tears. ITBS. Osgood - Schlatters
MCL SPRAIN Palpable pain along medial knee. MOI is VALGUS STRESS. Local swelling, NO effusion. May be unstable ( not always in grade 1 ). VALGUS stress test.
LCL SPRAIN Less common injury. MOI is VARUS STRESS. Palpable lateral tenderness. Usually involves other structures. May feel unstable
ACL INJURY Most taut @ 30' of knee flexion. Often injured while making a cut. Often a a NON contact injury.
ACL TEAR MOI is twisting / rotation @ 30' of flexion. Can be injured in HYPEREXTENSION. Often feels a POP. Describes instability. Immediate effusion in about 6 hours. Unable to continue participation. Recommended reconstructive surgery.
ACL RECONSTRUCTION ACL will not heal. Make a new one using cadaver, PATELLOR TENDON, HAMSTRING TENDON. 6 month recovery.
PCL TEAR Less common then ACL. Often feels a POP. DASHBOARD MOI blow to the anterior tibia. Can heal WITHOUT surgery.
Posterior Sag Sign PCL - Most taut @ 90'. Sag sign if torn. Tibia sits back on femur if torn.
MENISCUS TEARS MOI - TWIST with WEIGHT BEARING. May hear POP. JOINT line pain inside knee. Effusion within 12 hours. Clicking or popping catching or locking. Chronic - Water On The Knee ( swelling ).
MENISCUS TEARS Peripheral tear ( RED ZONE ) may heal with stiches or darts. Interior tear ( WHITE ZONE ) Needs Surgery ( reshaping )
Patellar TENDINITIS Jumpers Knee. Chronic. Repetitive Stress. Point tender on tendon, inferior of patella.
Patellar TENDINITIS Treatment Decrease inflammation. Stretch Hams / Quads. STRENGTHEN Quads. Band or Strap.
CHONDROMALACIA Patella Softening of UNDERSIDE of patella. Articular Cartilage Damage. Tracking Problems. Pain around Patella. Crepitus. Damage causes the inflammation.
CHONDROMALACIA Patella TREATMENT Decrease inflammation. Stretch Hams / Quads. STRENGTHEN Quads. Brace for tracking.
Patella DISLOCATION / SUBLUXATION Biomechanics or trauma. MORE COMMON in women. Dislocates LATERALLY only. May hear 2 POPS ( in / out ).
ITBFS Illiotibial Band Friction Syndrome or IT BAND
ITBFS Thick band from( TENSOR FASCIA LATA ) along outside of knee to anterolateral tibia. Rubs over lateral femoral condyle with FLEXION and EXTENSION. RUNNERS KNEE. Pain over lateral knee.
Osgood - Schlatters Repeated pull of patellar tendon @ growth plate. Adolescents. Point tender @ attachment. Pain with kneeling, running, and jumping.
PREVENTION AND REHAB Strengthening - VMO ( medial quad ) for patella tracking. BIO mechanics, Foot patellar. Knee alignment.
PREVENTION AND REHAB Bracing - preventative for contact sports. Post injury ( ligaments and alignment ).
Created by: gstewart