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Knee Conditions
| Question | Answer |
|---|---|
| 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 ) |
| PATELLOFEMORAL DISORDERS | Patellar TENDINITIS, Patellar SUBLUXATION , Patellar DISLOCATION, Chondromalcia, BIOMECHANICAL ABNORMALTIES. Weak ( VMO ) Quads. Tight Quads or Hams. |
| 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. |
| ITBFS treament | STRETCHING - ICE - MASSAGE |
| Osgood - Schlatters | Repeated pull of patellar tendon @ growth plate. Adolescents. Point tender @ attachment. Pain with kneeling, running, and jumping. |
| PREVENTION AND REHAB | Stretching - HAMS QUADS GASTROC IT BAND ADDUCTORS HIP FLEXORS |
| 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
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