Advanced Sports Medicine - The Knee

For every cute adv sports med bae.

Radial meniscus tear

Longitudinal meniscus tear

Bucket handle meniscus tear

Valgus Stressor

Medial force on knee

Varus Stressors

Lateral forces on knee

Hamstring muscle group

Biceps femoris, semi membranous, semi tendinous

Pes Anserine muscle group

Sartorius, semi tendinous, gracilis

Muscles responsible for internal rotation

Sartorius, semi tendinous, gracilis (Pes anserine), popliteus, semi membranous

Muscles responsible for external rotation

Biceps Femoris

Muscles responsible for extension

Quadriceps (vatus lateralis, rectus femoris, vastus medialis)

Q-angle standards (Measured from anterior superior iliac spine to patella to tibial tuberosity)

Male: 10 degrees Female: 15 degrees

A-angle standards (Measured from patellar apex to tibial tuberosity)

>35 degrees is a bad sign

Genu valgum or “Knock knees”

knees move inwards towards each other, compresses lateral meniscus, stresses MCL

Genu varum or “Bow legged”

Hyperextended knees, internal rotation of tibia, can cause rickets (soft bones), stresses LCL, compresses medial meniscus and IT band

Genu recurvatum

Hyperextended knees, lordosis (excessive curve of lumbar spine), stresses ACL and PCL + gastrocnemius, popliteus, plantaris

Patella Alta

Patella rests superiorly, tendon ratio is greater than 1:1

Patella Baja

Patella rests inferiorly, tendon ration less than 1:1

Tibial torsion (measures rotation of tibia)

< or > 15 degrees is a BAD sign

Femoral anteversion “pigeon toed”

Internal rotation of femur, caused by internal rotation of >70 degrees

Femoral retroversion “Duck footed”

External rotation of femur, caused by external rotation of >45 degrees

MCL Sprain causation

Involves medial meniscus occasionally, caused by varus (lateral) force

LCL Sprains causation

Caused by valgus (medial) force, complete tears involve PCL and occasionally ACL

ACL Sprains causation

Sprained by non contact situations the most out of ligaments, caused by twisting and hyperextension of knee, caused by valgus (lateral) force

Unhappy Triad

Injury of MCL, medial meniscus, and ACL

PCL Sprains causation

Usually injured among other ligaments, caused by forced hyperflexion (movement is likely to also tear ACL), falling on a bent knee

Allograft

ACL repair from a dead person

Autograft

ACL repair from own body (patellar tendon, semi tendinous, gracilis)

Meniscectomy

Either partial (inner 1/3) or full removal of meniscus

Meniscal injuries causation

Forceful internal rotation/external rotation while flexing or extending knee (courtesy lunges)

Meniscal Repair

Outer 2/3 of meniscus repaired

Patellar dislocation/ subluxations causation - conditional

• Genu valgum

• Genu recurvatum

• Patella alta

• Weak vastus medialis

• Probated feet (waking on inner portion of feet)

Patellar dislocation/ subluxations causation - action

Planting foot, decelerating, changing directions + hit on medial side of knee while planted

IT Band friction syndrome causation

• Leg length discrepancy

• Tight quads/hams

• Genu varum

• Excessive foot pronation

• Tight heel cord

• Running on uneven surfaces such as running down hills

IT Band friction syndrome

Friction with lateral femoral epicondyle, tenderness, crepitus, swelling

Osgood-Schlatters

Avulsion fracture of tibial tuberosity

Osgood-Schlatters causation

Growing too fast, tight quads, repetitive jumping

Screw home mechanism

The mechanism in which the tibia rotates in order to lock the knee

Two tendons that support the patella

Quadricep & patellar tendon

Medial meniscus tear

forceful internal/external while locked at 10-30 degrees

Lateral meniscus tear

forceful internal/external while locked at 70 degrees

Structures concerned with genu valgum

Compressed lateral meniscus, stressed MCL

Structures concerned with genu varum

Stressed LCL, compressed medial meniscus and IT band

Structures concerned with genu recurvatum

Stressed ACL + PCL, gastrocnemius, popliteus, plantaris

Bones the make up the knee

Femur, tibia, patella, femur

Muscles that perform knee flexion

Biceps femoris, planatris, popliteus, semi membranosous, semi tendonosous, sartorious, gracilis, gastronemius

Quadriceps muscle group

Vastus lateralis, rectus femoris, vastus medialis

Another name for patellar tendinitis

Jumper’s knee

Structure that connects each menisci

Transverse ligament

Attachment site on tibia for quad muscles

Tibial tuberosity

Patellar tendinitis

Inflammation of patellar or quadricep tendon, caused by overuse (repetitive jumping)

Purpose of medial collateral ligament

Protects against valgus (medial) stressors

Purpose of lateral collateral ligament

Protects against varus (lateral) stressors

Purpose of anterior cruciate ligament

Stabilizes against internal rotation, prevents tibia from moving anteriorly

Purpose of posterior cruciate ligament

Prevents hyperextension, posterior movement of tibia, and internal rotation