The Knee

What is the eitiology (cause) of an ACL tear?

Non-contact pivoting, tib translates ant while the knee is slightly flexed and in valgus.

Clinical manifestations of ACL tear

Sensation of popping, tearing, hemarthrosis, inability to weight bear, and sudden pain.

Pathogenesis (what) of ACL tear

Destabilisation swelling and effusion immediately occur. Hemarosis occurs rapidly. Inflammatory cytokines and matrix metalloprotienases contribute to joint degradation if not managed.

What is the Eitiology & Pathogenesis for ITB syndrome?

Repetitive friction of the ITB and lateral epicondyle during flexion & extension. 
Compression of the fat pad and inflmamtion of the bursa is implicated as a source of px.

Clinical manifestations of ITB syndrome

Sharp burning lateral knee pain. Worsens with running, especially downhill and cycling.
Pain typically starts after a certain time or distance and worsens the longer the activity continues.

Treatment implication for ITB syndrome

Rest and activity modification
NSAIDs, Ice
Stretching and strengthening

Epdiemiology of ITB syndrome

Long distance runners
Cyclists
Skiers
More woman than men

What percentage of the world’s OA cases are in the knee?

80%

What are the key etiological factors in knee OA?

Cartilage degredation
Osteophyte formation
Meniscal damage
Synovial inflammation

Clinical manifestations of knee OA

Px, crepitus, stiffness, joint line tenderness, limited ROM, bony deformation on palpation

Treatment implications for knee OA

Activity modification
Episodic NSAID’s
Braces
Physical therapy

What distinguishes primary from secondary knee OA?

• Primary OA: Articular degeneration without an apparent cause.

• Secondary OA: Caused by abnormal force concentration across the joint, and RA, or previous truama

What are some common fractures of the knee

Tibial plateau and patellar

What are the common ligament strains of the knee

MCL, LCL, ACL, PCL