chap 14 (knee injuries)-sports med

bones in knee

femur, tibia, fibula, patella

keeps tibia from moving forward on femur, responsible for majority of knee stability

anterior cruciate ligament (ACL) function

prevents tibia from moving backwards on femur

posterior cruciate ligament (PCL) function

provides stability to the inside (medial) aspect of knee

medial collateral ligament (MCL)

provides stability to the outside (lateral) aspect of knee

lateral collateral ligament (LCL)

cartilage; provides cushion so femur and tibia don't rub against each other

meniscus

medial meniscus shape

c-shaped

lateral meniscus shape

o-shaped

muscles of knee

quadriceps and hamstrings

injury prevention

stretch and strengthen quads, hamstrings, calves

genu valgus

structural deformity, knock knees

genu varus

structural deformity, bow legged

ACL sprain mechanism

hyperextension, hyperflexion, twisting on planted foot deceleration, cutting

ACL sprain symptoms

giving way/instability, pain swelling popping

ACL sprain treatment

RICE, surgery, physical therapy, recovery 9-monts

PCL sprain mechanism

hyperextension, fall on flexed knee

PCL sprain

much less common, ligament very strong

PCL sprain symptoms

sulcus sign-concave appearance, pain swelling popping, instability

MCL sprain mechanism

blow to outside of leg, valgus force

MCL sprain symptoms

pain along medial aspect of knee, swelling instability

MCL sprain treatment

immobilization, rehab, surgery not common

LCL sprain mechanism

blow to inside of leg, varus force

LCL sprain symptoms

tenderness and pain along lateral knee

patellar tendonitis

jumpers knee, overuse, pain over patellar tendon, treatment: quadricep stretching, tape/brace

pes anserine tendonitis

a combined tendon of gracilis, sartorius, and semitendinosus, often overuse, associated w/ runners, tape/brace

patella femoral syndrome

aka chondromalacia, cartilage behind the patella becomes worn away

patella femoral syndrome symptoms

pain/discomfort around patella, grinding feeling

patella femoral syndrome mechanism

often caused by patella tracking problems, running (hills), squatting, up/down stairs

patella tracking problems

patella moves in different direction when flexing/extending

patella femoral syndrome treatment

stretch tight muscles, restore muscle balance, taping/bracing, surgery for lateral release

dislocated patella

when patella comes out of femoral groove, usually laterally

more vulnerable to dislocated patella

often related to developmental condition: increased quadricep angle, weak vastus medialis, shallow patella femoral groove

dislocated patella symptoms

extreme pain, obvious deformity, unable to move

dislocated patella mechanism

strong quadriceps contraction w/ valgus position, bent knee and twisting force

bone from underneath cartilage dies from lack of blood flow, bone and cartilage pieces can break off, cause problems in joint spaces

osteochondritis dissecans (OCD)

osteochondritis dissecans (OCD) symptoms

pain, weakness, joint popping and locking, swelling, joint stiffness

medial meniscal tears mechanism

twisting knee w/ foot planted, lower leg externally rotated

lateral meniscal tears mechanism

twisting knee w/ foot planted, lower leg internally rotated

meniscal tears symptoms

pain/swelling along joint line, pain w/ twisting or squatting, clicking, catching, popping, locking,

unhappy triad

ACL, MCL, medial meniscus are all torn; mechanism: valgus force w/ foot planted

occurs when there is too much meniscus damage, articular cartilage worn away, bone to bone rubbing

osteoarthritis

osteoarthritis cause/symptoms

cause: age, weigh, joint injury symptoms: stiffness, crunching feeling

pain on the tibial tuberosity due to a growth spurt, common in adolescence, treatment: quad stretching or patellar tendonitis strap

osgood-schlatter disease

what is this?

knock knees or ganu valgus

what is this?

bow-legged or ganu varus

what is this? what injury is it related to?

sulcus sign, injury is PCL sprain

what injury is this?

osgood-schlatter disorder

what injury is this?

MCL sprain

what injury is this?

medial meniscus tear

what injury is this?

osteoarthritis

what injury is this?

chondromalacia or patella femoral syndrome

what injury is this?

OCD or osteochondritis dissecans

what injury is this?

ACL sprain

special test and implication

valgus stress test; medial collateral ligament (MCL) sprain

special test and implication

varus stress test; lateral collateral ligament (LCL) sprain

special test and implication

anterior drawer test; anterior cruciate ligament (ACL) sprain

special test and implication

lachman’s test; anterior cruciate ligament (ACL) sprain

special test and implication

posterior drawer test; posterior cruciate ligament (PCL) sprain

special test and implication

apley’s compression and distraction tests; meniscal tears

special test and implication

mcmurray’s test; meniscal tears