Slide 2 KNEE INJURIES Review Gross and Functional Anatomy.
Discuss traumatic injuries to the knee. Discuss overuse injuries in
and about the knee. Slide 3 KNEE INJURIES Discuss the signs and
symptoms of the specific injuries. Discuss causes and treatments.
Slide 4 KNEE (Anterior view) Slide 5 Slide 6 Slide 7 Slide 8
BEHAVIORAL CHARACTERISTICS OF STRUCTURES AROUND THE KNEE Slide 9
ANTERIOR CRUCIATE LIGAMENT LOCATION Slide 10 Slide 11 POSTERIOR
CRUCIATE LIGAMENT LOCATION Slide 12 Slide 13 STABILIZING ROLE OF
THE ANTERIOR CRUCIATE LIGAMENT Slide 14 Slide 15 HEAT SENSITIVE
VIEWS OF THE ANTERIOR CRUCIATE IN FLEXION Slide 16 Slide 17
STABILIZING ROLE OF THE POSTERIOR CRUCIATE LIGAMENT Slide 18 Slide
19 HEAT SENSITIVE VIEW OF THE POSTERIOR CRUCIATE IN FLEXION AND
EXTENSION Slide 20 Slide 21 A.C.L. and P.C.L. LINKAGE Slide 22
Slide 23 MEDIAL COLLATERAL LIGAMENT DURING FLEXION AND EXTENSION
Slide 24 Slide 25 LATERAL VIEW OF KNEE FLEXION and EXTENSION Slide
26 Slide 27 PATELLO-FEMORAL JOINT DURING FLEXION AND EXTENSION
Slide 28 Slide 29 Slide 30 NORMAL KNEE MOTION KNEE
FLEXION-EXTENSION takes place between the bottom of the femur and
the top of the menisci. TWISTING MOTION takes place between the
bottom of the menisci and the tibia. Slide 31 MENISCUS OF THE KNEE
Purpose: Equalize weight distribution across the knee joint. Shock
absorption. Slide 32 Coronary Ligament Medial is tighter than the
lateral. Thus, there is less mobility medially. Slide 33 MENISCAL
INJURY Medial Meniscus: excessive external rotation of the tibia.
Lateral Meniscus: excessive flexion of the knee. Slide 34
MECHANISMS OF INJURY VALGUS VARUS HYPEREXTENSION HYPERFLEXION
INTERNAL ROTATION EXTERNAL ROTATION Slide 35 X VALGUS Distal bone
of the joint moves away from midline of the body. Slide 36 Slide 37
Medial Support Complex Medial Hamstrings Medial Head of
Gastrocnemius Not Shown: Quads Slide 38 Slide 39 X VARUS Distal
bone of the joint moves towards the midline of the body Slide 40
Slide 41 Slide 42 Lateral Support Complex Poplitius Tendon Head of
the Gastrocnemius Not Shown: Iliotibial Band Biceps Femoris M.
Slide 43 Slide 44 ANTERIOR CRUCIATE Slide 45 Slide 46 Slide 47
Slide 48 Slide 49 Slide 50 Slide 51 Posterior Cruciate Ligament
Impact on anterior tibia. Slide 52 Slide 53 Slide 54 Rotation
Affecting Tension Slide 55 Valgus with External Rotation of the
Knee. M.C.L Deep, Superficial and A.C.L. Slide 56 Slide 57
Mechanisms of Injury MCL Valgus of Knee ACL Valgus after MCL
Extension with tibia in internal rotation. Hyperextension. Slide 58
PCL Valgus after MCL and ACL. Varus after LCL,ACL Hyperflexion with
tibial internal rotation. Blunt trauma to tibial tuberosity. Slide
59 FCL Varus of knee. M.M. External rotation of the tibia. Valgus
to knee. L.M. Hyperflexion of the knee. Slide 60 SIGNS AND SYMPTOMS
OF LIGAMENT INJURY (Not all symptoms have to be present to indicate
injury) Immediate pain ++++ Feeling of tearing. Hearing unusual
noises. . 2. Slide 61 .. 2 Signs and Symptoms Feeling of giving
way. Loss of function of the joint Be cautious of the painful and
then not very painful knee. Slide 62 REMOVAL FROM FIELD (Non-weight
Bearing) Feeling of a tearing or popping in the knee. If pain, no
pain. Slide 63 REMOVAL FROM FIELD (Non-weight bearing) If
complaining of not feeling right or feeling funny Slide 64 REMOVAL
FROM FIELD Weight bearing Minor pain with full R.O.M. Stand. Pain?
Slowly walk off field with support. Slide 65 Return to play only
after the athlete has been evaluated by a physician. Slide 66 Slide
67 Patello-femoral Pain Syndrome. Iliotibial Band Friction
Syndrome. Osgoode Schlatters Disease. Slide 68 Slide 69
PATELLO-FEMORAL PAIN SYNDROME Causes:. Excessive Q angle..
Excessive pronation.. Weak plantar flexors/inv.. Weak V.
Medialis/Tight Ham Slide 70 Q Q ANGLE (Quadriceps) Two lines; ASIS
to MPP; the other from TT to MPP. Angle of intersection called Q
angle. Slide 71 The greater the Q angle, the greater the tendency
to move the patella laterally against the lateral femoral condyle.
A large Q angle plus strong quad contraction can dislocate pat.
Slide 72 Slide 73 Equal pressure distribution across the back of
the patellae ensures proper nutrition by inbibition. Slide 74
Medial aspect of Patellofemoral Joint has hypopressure. Lateral
aspect has hyperpressure. + - - + Slide 75 Slide 76 Signs and
Symptoms of Patello-femoral Pain Syn. Painful crepitus of the knee.
Locking, catching of knee. Swelling. Loss of strength. Activity
worsens symptoms. Slide 77 SUGGESTED TREATMENTS Strengthen Vastus
Medialis. Reduce Pronation. Stretch Hamstrings, ITB, and Quads.
Modify activities. Slide 78 Slide 79 The greater the Q angle, the
greater the tendency to move the patella laterally against the
lateral femoral condyle. A large Q angle plus strong quad
contraction can dislocate pat. Slide 80 My knee came apart and went
back together again. For example, I was running forward, planted on
my right foot, cut to my left and attempted to push off with my
right. Slide 81 Lateral Medial SUBLUXED OR DISLOCATED PATELLA Slide
82 DISLOCATED PATELLA Slide 83 If the patella is dislocated,
slightly flex the hip and slowly extend the knee. Usually the
patella relocates. If it does not, do not force the patella medial.
There may be some associated fractures (back of the patella,
lateral femoral condyle). MEDICAL Slide 84 Iliotibial Band Friction
Syndrome Slide 85 I.T.B.F.S. Predisposing Factors Tight Tensor
Fascia Lata and weak Gluteus Medius. Genu Varum Downhill Running
Training Errors Slide 86 Slide 87 I.T.B.F.S. Treatment Modification
of Activity and shoes. Stretching. Icing after activity.
Strengthening. Slide 88 Iliotibial Band And Hip Abductor Stretch
Slide 89 OSGOODE SCHLATTERS DISEASE Slide 90 Slide 91 Osgoode
Schlatters Separation of the traction epiphysis of the quadriceps
muscle. Active pre-pubescent kids. No gender bias. Slide 92 Signs
and Symptoms: Pain increase with activity. Tibial tubercle is warm
to touch. Pain on squeezing the tibial tubercle from sides. Slide
93 Slide 94 Inform parents. Stop irritating activity. Icing the
tibial tubercle. Stove-pipe casts are some- times applied to ensure
rest. Return if asymptomatic.
