Knee

Question 1

What is known about the knee joint in the body?

Answer 1

Largest joint in the body
Key in locomotive activities
Inherently unstable from its bony arrangement

Question 2

What does the knee work in concert with?

Answer 2

Ankle

Hip

Question 3

Where does the knee get its stability?

Answer 3

Ligamentous investment

Muscular invesment

Question 4

What are the different articulations that make up the knee?

Answer 4

Tibial-femoral (femoral meniscus, meniscal tibial)
Paterllar femoral
Superior tibial-fibular
Inferior tibial-fibular

Question 5

How many degrees of freedom in the knee?

Answer 5

2-3 degrees if you count the screw-home mechanism

Question 6

What are four things about the femur?

Answer 6

A-P convexity is inconsistent
A smaller radius of curvature posteriorly
Medial femoral condyle 2/3” longer and extensds further distally
6 degrees of valgus

Question 7

What are five things about the tibia?

Answer 7

Two asymmetrical concave articulating plateaus
Medial tibia plateau is 50% larger than lateral
Two fibracartilagenous discs (menisci) increase congruency
Medial meniscus is shaped as a semicircle, the lateral 4/5ths of ring
Medial meniscus has decreased mobility, increases susceptibility

Question 8

What are the five ligaments of the knee?

Answer 8

Medial collateral
Lateral Collateral
Anterior cruciate
Posterior cruciate
Coronary

Question 9

What are the three aspects of the medial collateral ligament?

Answer 9

Two layered structure
Deep layer is intimately associated with the joint capsule
Superficial layer is a broad triangularly shaped structure

Question 10

What are the four aspects of the lateral collateral ligament?

Answer 10

A rounded shaped structure
Is located more posteriorly than appreciated
Lies under biceps femoris tendon
Independent- may have bursa between it

Question 11

What are the four aspects of the anterior cruciate ligament?

Answer 11

Is intracapsular, yet extrasynovial (blood from bone)
Named by its tibia attachment
Extends superiorly, posteriorly, and laterally
Checks: Anterior translation, lateral rotation in flexion, extension, and hyperextension

Question 12

What are the four aspects of the posterior cruciate ligament?

Answer 12

Is intracapsular, yet extrasynovial
Named by its tibia attachment
Extends superiorly, anteriorly, and medially
Checks: Posterior glid, extension, and hyperextension

Question 13

What is the aspect of the coronary ligament?

Answer 13

Attaches menisci to the tibia

Question 14

What happened if swelling occured immediately (1-2 hours) after injury and consists of blood?

Answer 14

Internal ligament tear, osteochondral fracture, or peripheral meniscus tear (doughy, taut)

Question 15

What happened if swelling is delayed (8-24 hours) and synovial swelling?

Answer 15

Joint irritation (boggy feeling)

Question 16

What happened if the swelling is hot?

Answer 16

Purulent (pus) red, infection

Question 17

What plane and normal range of motion for flexion and extension?

Answer 17

Sagittal/frontal axis

0-135 degrees

Question 18

For flex/ext what happened with a ROM at -10 and -145?

Answer 18

• 10=hyperextension

- 145=flexion contracture

Question 19

What is the minimum angle for gait?

Answer 19

60 degrees

Question 20

What is the plane and normal ROM for Medial/Lateral rotation?

Answer 20

Transverse/Longitudinal axis
Medial=30
Lateral=40

Question 21

What is the plane and axis for abduction/adduction?

Answer 21

frontal/sagittal axis

Question 22

What is the first 25 degrees of flexion?

Answer 22

Rolling of the femoral condyles on the tibia

Question 23

What occurs after the first 25 degrees of flexion?

Answer 23

Rolling is accompanied by a simultaneous glide of the femur (or posterior glide of tibia)

Question 24

For flexion of the knee what occurs with the osteo/arthro kinematic relationship?

Answer 24

They are the same

Question 25

What causes ligamentous injuries?

Answer 25

Ill fated structures
Connects two long lever arms
Slower angular velocity force introduction

Question 26

What causes meniscus injuries?

Answer 26

Too much Compression
OA-simple wear and tear
Impaired transverse plane motion
Impaired mobility of mensici

Question 27

What causes bone injuries?

Answer 27

Fractures

Question 28

What is Osteochondritis Dissecans?

Answer 28

Partial or complete detachment of a gragment of cartilage and subchondral bone

Question 29

What is Osgood-Schlatter?

Answer 29

Partial separation of the tibial tuberosity (Young kids as catcher)

Question 30

What is bursitis?

Answer 30

Inflammation of the bursa

18 or more bursa around the knee

Question 31

What other diseases can affect the knee?

Answer 31

DJD/OA/RA

Question 32

What does abnormal patellar tracking result from?

Answer 32

The inability of the patella to tilt, slide, glide and rotate
Weakness of quadriceps and hip abductors or external rotators
Chondromalacia Patella

Question 33

What causes lateral tracking of the patella?

Answer 33

Tight lateral structures and increased Q-angle (normal 8-15degrees from ASIS to Mid patella to tibial tuberosity)

Question 34

What is tight with Laterally directed forces?

Answer 34

Iliotibial band

Lateral patellar retinacular fibers

Question 35

What is tight with medially directed forces?

Answer 35

Vastus medialis

Medial patellar retinacular fibers

Question 36

What can create pathologic forces?

Answer 36

Large loads in excessive flexion

Question 37

What are pathological patellofemoral joint forces?

Answer 37

Patella Alta

Patella Baja

Question 38

What is patella alta?

Answer 38

Patella rides high on the groov

Patellar tendon is too long

Question 39

What is patella baja?

Answer 39

Patella rides low on groovee

Patellar tendon is too short