Knee Conditions
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| Knee Joint Mechanics | Occurs between the TIBIA and the FEMUR
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| Knee Joint Mechanics | flexion and extension
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| Patellofemoral Joint | Patella glides up and down in a Groove on the Femur
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| Knee Joint Muscles | QUADS, HAMS, GASTROC, Others
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| Knee Ligaments | ACL PCL MCL LCL
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| Collateral | on one side
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| Cruciate | To Cross
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| MCL | Medial ( TIBIA ) Collateral Ligament - most injured. Attaches from Tibia to Femur. Prevents VALGUS ( knock knee ) stress. Broad Ligament.
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| LCL | Lateral ( fibular ) Collateral Ligament. Attaches from Fibula to Femur. Prevents VARUS ( bow legged ) stress. Small, rounded lig.
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| 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.
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| PCL | Posterior Cruciate Ligament. Attaches on Posterior tibia to anterior femur. Prevents posterior displacement of tibia on femur. Deep and not palpable.
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| Knee Cartilage | There are 2 kinds, Articular or Hyaline and Meniscus.
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| Articular Cartilage | On the ENDS of BONE. Provides for a smooth gliding motion.
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| MENISCUS | Fibrocartilage - shock absorber.
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| 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
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| Patellorfemoral Joint | Articulation between the Patella and Femur. Patella has a V shape posteriorly. Glides in groove on femur.
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| Knee Evalution | History. History. History
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| 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.
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| Knee Observation | Bilateral Comparison. SWELLING, discoloration, ATROPHY, deformity.
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| JOINT EFFUSION | Swelling in joint capsule.
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| Palpation | Feel for tenderness - Patellar TENDON. MCL / LCL. Joint line for meniscus. MILKING TEST for swelling.
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| RANGE OF MOTION | Flexion and extension of knee.
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| Muscle Testing | Resist Flexion for hams. Resist Extension for quads.
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| Muscle Testing | Perform Bilaterally
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| Special Test | Ligament Laxity - ACL - PCL - LCL - MCL. Meniscus Tests. Patellar Subluxation. Patellofemoral Dysfunction Test.
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| INJURIES | Ligament Sprains - Grades 1-2-3. Patellar Tendinitis. Patella Subluxation or Dislocation. Chondromalacia Patella. Meniscus Tears. ITBS. Osgood - Schlatters
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| 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.
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| LCL SPRAIN | Less common injury. MOI is VARUS STRESS. Palpable lateral tenderness. Usually involves other structures. May feel unstable
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| ACL INJURY | Most taut @ 30' of knee flexion. Often injured while making a cut. Often a a NON contact injury.
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| 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.
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| ACL RECONSTRUCTION | ACL will not heal. Make a new one using cadaver, PATELLOR TENDON, HAMSTRING TENDON. 6 month recovery.
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| PCL TEAR | Less common then ACL. Often feels a POP. DASHBOARD MOI blow to the anterior tibia. Can heal WITHOUT surgery.
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| Posterior Sag Sign | PCL - Most taut @ 90'. Sag sign if torn. Tibia sits back on femur if torn.
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| 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 ).
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| MENISCUS TEARS | Peripheral tear ( RED ZONE ) may heal with stiches or darts. Interior tear ( WHITE ZONE ) Needs Surgery ( reshaping )
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| PATELLOFEMORAL DISORDERS | Patellar TENDINITIS, Patellar SUBLUXATION , Patellar DISLOCATION, Chondromalcia, BIOMECHANICAL ABNORMALTIES. Weak ( VMO ) Quads. Tight Quads or Hams.
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| Patellar TENDINITIS | Jumpers Knee. Chronic. Repetitive Stress. Point tender on tendon, inferior of patella.
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| Patellar TENDINITIS Treatment | Decrease inflammation. Stretch Hams / Quads. STRENGTHEN Quads. Band or Strap.
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| CHONDROMALACIA Patella | Softening of UNDERSIDE of patella. Articular Cartilage Damage. Tracking Problems. Pain around Patella. Crepitus. Damage causes the inflammation.
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| CHONDROMALACIA Patella TREATMENT | Decrease inflammation. Stretch Hams / Quads. STRENGTHEN Quads. Brace for tracking.
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| Patella DISLOCATION / SUBLUXATION | Biomechanics or trauma. MORE COMMON in women. Dislocates LATERALLY only. May hear 2 POPS ( in / out ).
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| ITBFS | Illiotibial Band Friction Syndrome or IT BAND
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| 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.
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| ITBFS treament | STRETCHING - ICE - MASSAGE
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| Osgood - Schlatters | Repeated pull of patellar tendon @ growth plate. Adolescents. Point tender @ attachment. Pain with kneeling, running, and jumping.
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| PREVENTION AND REHAB | Stretching - HAMS QUADS GASTROC IT BAND ADDUCTORS HIP FLEXORS
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| PREVENTION AND REHAB | Strengthening - VMO ( medial quad ) for patella tracking. BIO mechanics, Foot patellar. Knee alignment.
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| PREVENTION AND REHAB | Bracing - preventative for contact sports. Post injury ( ligaments and alignment ).
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Created by:
gstewart
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