the knee from the sports medicine perspective bony anatomy femur patella tibia fibula
TRANSCRIPT
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The Knee
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From the Sports Medicine Perspective
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Bony Anatomy
Femur
Patella
Tibia
Fibula
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Bony Anatomy
Femur: Longest Bone in BodyTibia: WB bone of lower extremityFibula: Site of Muscle AttachmentPatella: Sesamoid Bone
A bone that develops within a tendon
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Knee Skeletal
Lateral Condyle
Head of Fibula
Femoral Groove
Gerdy’s Tubercle
Tibial Tuberosity
Pes Anserine
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Sagittal MRI View
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Knee Connective Tissue
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Knee Menisci
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Menisci
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Menisci
Medial Meniscus
Lateral Meniscus
PCL
ACL
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Knee Ligaments
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Medial Collateral LigamentMCL
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MCL
Thick Band of TissueTibia FemurResists Valgus Force
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Valgus
Outside to Inside Force
MCL resists this force
Occurs in FRONTAL PLANE
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Lateral Collateral Ligament LCL
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LCL
Narrow cord like band of tissueFibula FemurResists Varus Forces
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Varus
Inside to Outside Force
LCL resists this forceFRONTAL PLANE
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Increased Valgus
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Collateral Ligament Ruptures
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Ligament Structures
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Anterior Knee
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Anterior Cruciate Ligament ACL
Composed of 3 bandsPrevents anterior
translation of tibiaStabilizes against
excessive rotationStabilizing Ligament
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Healthy ACL
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Torn ACL
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Knee Posterior
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Posterior Cruciate Ligament PCL
Stabilizes the posterior aspect of knee
Prevents hyperextension
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Cadaver Knee
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Quadriceps
Anterior Thigh Musculature
Four Muscles:Rectus FemorisVastus LateralisVastus MedialisVastus Intermedius
Extend the Knee
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Quadriceps
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Rectus Femoris
2 Joint MuscleCrosses hip and knee
Flexes HipExtend the kneeConverges with rest
of quadriceps muscles at tibial tubercle
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Hamstrings
Three MusclesSemimembranosusSemitendinosusBiceps Femoris
Common Origin the ischial tuberosity
Flex the Knee
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Hamstrings
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Popliteus
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Popliteus
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MCL Sprains
Valgus ForceTensile Mechanism
MCLFlexed knee more
vulnerable (open pack position = less stable)
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MCL Injuries
Direct trauma in frontal plane injures MCL
Combination of rotation can result in ACL and meniscus tears
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MCL/LCL Injuries
GRADE I: No instabilityMild EffusionROM fullMild tenderness w/
palpation
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MCL/LCL Injuries
GRADE II: Laxity w/ valgus or
varus stress (more with 30 degrees of flexion)
Decrease in ROMIncrease medial
(MCL) or lateral (LCL) pain
GRADE III:Complete ligament
ruptureComplete loss of
stabilityImmediate pain that
transitions into dull ache
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Treatment
Based on severity of injury
RICEModify activityCrutchesExercises in sagittal
planeProgress to
functional exercise