Ch. 18 Knee Injuries

Ch. 18 Knee InjuriesKnee

Genu Valgum (knocked knee)Genu Varum (Bow legged)Genu Recurvatum (hyperextension)Patellofemoral PainDifficult injury to deal with because the MOI may be hard to isolateMOI: prolonged knee flexion, stairs, squats, runningS/S: pain in the front of the knee or behind the kneecap, knee giving way, crepitus, mild swellingPatellofemoral PainTreatment: correct biomechanics that is causing misalignment, strengthen quads, patella tape, orthotics, braces

Patella TendonitisJumpers KneeMOI: sprinting, jumping, quick change in directions, repetitiveS/S: anterior knee pain below patellaTreatment: modify activity, ice, patella strap

Patella DislocationMOI: knee bent and forced inwardS/S: obvious deformity, pain, immediate swellingTreatment: reduce, immobilize, check ligaments, RICERehab: strengthening, ROM

Osgood-SchlatterInvolves tibial tubercle epiphysisMales 12-16, Females 10-14MOI: traction of quadsS/S: pain, swelling, weakness in quads, lump, pain with palpation

Osgood-SchlatterTreatment: control pain, swelling, and flexibilityWear protective pad or knee sleeveIce after all activityTake NSAIDsStretch hamstrings

IT Band SyndromeIliotibial Band: thick fibrous tissue on lateral side of thighITB Syndrome is irritation of the ITB when it crosses muscles and bone at lateral epicondyle

IT Band SyndromeCaused by increased mileage, foot and knee misalignment, leg length discrepanciesTreatment: RICE, stretch, correct biomechanical problems

MCLMOI: blow to outside of knee resulting in valgus forceS/S: pain on medial joint line or at attachments of MCL, decreased ROM, swellingTreatment: RICE, crutchesRehab: ROM, strengthening

ACLFemales who participate in basketball and soccer are four to six times more likely to tear ACL than males who play the same sport70% of ACL injuries in females are noncontactInfluencing factorsBiomechanical: quadriceps, landing HormonesEnvironmental: playing surface, shoe typeAnatomic: femoral notch, Q-angle

ACLMOI: noncontact or contact, rapid change of directionNo degreeseither torn or notS/S: pop, swelling, loose knee, painSpecial Test: Anterior Drawer, Lachmans, should be performed before guarding sets inDiagnosed with MRITreatment: RICE, crutches, knee immobilizer, surgery

PCLMost common MOI is car accident-knee hitting the dashboardUse sag test to diagnosisUsually non-surgicalRehab to restore strength and ROM

MeniscusMedial meniscus is attached more securely on the back and medial side of the knee. It does not more around easily which is why its torn more oftenMOI: sudden knee twistingS/S: clicking, pain with flexionAs one ages, meniscus lose rubbery consistency and tear more easily

Special TestsApprehension: Patella dislocationValgus Stress Test: MCLVarus Stress Test: LCLLachmens and Anterior Drawer: ACLPosterior Drawer: PCLMcMurrays: Meniscus

RehabROM: heel prop, heel slidesStrengthening: Straight leg raises, total knee extensions, step upsBalance: on foam pad, rebounderFunctional: speed ladder, carioca, cutting