1 / 19

The Knee and Related Structures

The Knee and Related Structures. Chapter 16. KNEE ANATOMY. Bones femur fibula tibia patella Articulations tibiofemoral patellofemoral. ANATOMY cont. Menisci Medial meniscus Lateral meniscus Blood supply (3 vascular zones) Versus hyaline cartilage Ligaments

nascha
Download Presentation

The Knee and Related Structures

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Knee and Related Structures Chapter 16

  2. KNEE ANATOMY • Bones • femur • fibula • tibia • patella • Articulations • tibiofemoral • patellofemoral

  3. ANATOMY cont. • Menisci • Medial meniscus • Lateral meniscus • Blood supply (3 vascular zones) • Versus hyaline cartilage • Ligaments • Medial collateral - MCL (deep & superficial) • Lateral collateral - LCL • Cruciates - ACL & PCL

  4. ANATOMY cont. • Joint Capsule • Synovial Capsule • Knee musculature • quadriceps group • hamstrings group • iliotibial band • gastroc, gracilis, sartorius, popliteus, plantaris • Patellar tendon

  5. ANATOMY cont. • Additional Knee Structures • Bursa • Popliteal fossa • Fat pads / plica • Nerves • Blood vessels

  6. KNEE ALIGNMENT DEVIATIONS • Patellar malalignments • Genu valgum • Genu varum • Genu recurvatum • Q angle

  7. KNEE INJURIESand CONDITIONS • FRACTURES • DISLOCATION • CONTUSIONS • SPRAINS • MENISCUS TEARS • the Unhappy Triad • SYNOVIAL PLICA SYNDROME

  8. INJURIES cont. • OSTEOCHONDRITIS DISSECANS • PATELLAR DISLOCATION/SUBLUX • CHONDROMALACIA • OSGOOD-SCHLATTER’S DISEASE • LARSEN-JOHANSSON • JUMPER’S KNEE • ILIOTIBIAL BAND SYNDROME • ARTHRITIS - DJD

  9. KNEE INJURY EVALUATION • HISTORY AND MECHANISM (MOI) • How did it happen / what happened? • previous injury or problems • acute or chronic problem • Sounds heard? • Returned to play? • PHYSICAL EXAM - SYMPTOMS • Pain, swelling, ROM, etc. • Areas of pain localized if possible

  10. EVALUATION cont. • SPECIAL TESTS • Valgus / Varus test • Drawer test • Lachman’s test (alternate Lachman’s?) • McMurray’s test • ADDITIONAL SPECIAL TESTS • X-ray and/or MRI • KT-1000 • Apley’s, Slocum’s, Rotary instability tests?

  11. Evaluation of Swelling • Sweep Test: • Determine swelling by manually moving the fluid in the knee from one side of the knee to the other. • Ballotable Patella Test: • Downward pressure on the patella is applied. A positive test is indicated by the patella bouncing back to its original position.

  12. Tests for ACL Instability • Drawer Test • Lachman’s Test • Alternate Lachman’s Test • Modified Lachman’s Test • KT 1000 Arthrometer

  13. Tests for PCL Instability • Posterior Drawer Test • Godfrey’s Test • Uses gravity to extenuate the posterior sag as noted by observation. Flex knees bilaterally to 90 degrees.

  14. Tests for Rotary Instabilities Clinically, athletes suffering from rotary instabilities will complain of the knee “going out”. • Slocum Drawer for Rotary Instability • Drawer test with int. & ext. rotation • Pivot Shift Test • Crossover Drill

  15. Tests for Meniscal Tears Meniscal injuries may often be in combination with other injuries to the knee, or they can be isolated. Immediate diagnosis is often difficult, but fortunately not an emergency. • McMurray’s Test • Apley’s Compression/Distraction Test

  16. Additional Conditions • Infrapatellar Fat Pad • Bursitis • Other Patello-femoral conditions • Extensor Mechanism problems • Osgood-Schlatter’s - Iliotibial band syn. • Larsen-Johansson disease - Pes Anserine syn. • Jumper’s knee - Collapsing knee • Patellar tendon rupture

  17. Knee Rehabilitation • General Conditioning • Weight Bearing • Knee Joint Mobilization • Flexibility • Muscular Strength • Neuromuscular Control • Bracing

  18. Summary • Knee Injuries are of Increasing Concern • Most common injuries are sprains of MCL, ACL, and LCL; meniscal tears, and patello-femoral problems. • Prevention Seems to be Difficult • Braces have limited effect • Evaluation and Management of Knee Injuries Experience • Rehabilitation Following Injury will Vary

More Related