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Knee

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The knee is essentially made up of four bones, that support the knee and provide ... diseases, such as rheumatoid arthritis and systemic lupus erythematosus (lupus) ... – PowerPoint PPT presentation

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Title: Knee


1
Knee
  • Tibiofemoral Joint

2
  • Largest and most complex
  • Actually 3 joints within a single synovial cavity
  • Laterally tibiofemoral joint modified hinge
    joint between the lateral condyle of the femur,
    lateral meniscus and lateral condyle of the tibia
  • Medially tibiofemoral joint modified hinge
    joint between the medial condyle of the femur,
    medial meniscus and medial condoyle of the tibia
  • Intermediate patellofemoral joint planar joint
    between the patella and the patellar surface of
    the femur

3
  • The knee is essentially made up of four bones,
    that support the knee and provide rigid structure
    of the joint
  • femur
  • tibia
  • fibula
  • Patella

4
Movement at Knee
  • Flexion
  • Extension
  • Slight medial rotation
  • Lateral rotation
  • The main muscles that move the knee joint are the
  • quadricep and hamstring muscles. The quadriceps
  • attaches to the patella, and the patellar tendon
    connect
  • this muscle to the front of the tibia. When the
    quadricep
  • muscles contract the knee extends. In contrast,
    when the
  • hamstring muscles contract, they pull the knee
    into flexion.

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Ligaments
  • anterior cruciate ligament (ACL). The critically
    important ACL prevents the tibia from being
    pushed too far anterior relative to the femur.
  • posterior cruciate ligament (PCL)connects the
    posterior intercondylar area of the tibia to the
    medial condyle of the femur
  • ligamentum patellae the central portion of the
    common tendon of the Quadriceps femoris, which is
    continued from the patella to the tuberosity of
    the tibia.
  • medial collateral ligament (MCL a.k.a. tibial
    collateral ligament). The MCL protects the medial
    side of the knee from being bent open by a stress
    applied to the lateral side of the knee (a valgus
    / outward force).
  • lateral collateral ligament (LCL a.k.a. fibular
    collateral ligament). The LCL protects the
    lateral side from an inside bending force (a
    varus / inward force).
  • oblique popliteal ligament strengthens the back
    of the capsule of the knee joint. It is an
    extension of the tendon of the semimembranosus
    muscle.

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  • The knee joint also has a C-shaped piece of
    tissue which fits into the joint between the
    tibia and the femur, made of cartilage, which is
    called the meniscus or meniscal cartilage.
  • It helps to protect the joint and allows the
    bones to slide freely on each
  • other.

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Bursa
  • There are also a bursa, little fluid sacs that
    helps the muscles and tendons slide freely
  • Prepatellar between the patella and skin
  • Infrapatellar between the superior part of the
    tibia patellar ligament
  • Suprapatellar between the inferior part of the
    femur the deep surface of the quad. femoris
    muscle

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injuries
  • Most vulnerable joint to injury
  • Mobile, weight bearing
  • Stability depends on ligaments and muscles
  • Mechanical knee problems can be caused by
  • A direct blow or sudden movements that strain
    the knee
  • Osteoarthritis in the knee, resulting from wear
    and tear on its parts.

14
  • Inflammatory knee problems can be caused by
    certain rheumatic diseases, such as rheumatoid
    arthritis and systemic lupus erythematosus
    (lupus). These diseases cause swelling which can
    damage the knees permanently.
  • Chondromalacia (KON-dro-muh-lay-she-uh) occurs
    when the cartilage of the knee cap softens. This
    can be caused by injury, overuse, or muscle
    weakness, or if parts of the knee are out of
    alignment. Chondromalacia can develop if a blow
    to the knee cap tears off a piece of cartilage or
    a piece of cartilage containing a bone fragment.

15
  • The meniscus easily injured if the knee is
    twisted while bearing weight. A partial or total
    tear may occur. If the tear is tiny, the meniscus
    stays connected to the front and back of the
    knee. If the tear is large, the meniscus may be
    left hanging by a thread of cartilage. The
    seriousness of the injury depends on the location
    and the size of the tear.

16
Ligament Injuries
  • the anterior cruciate ligament (ACL) and the
    posterior cruciate ligament (PCL) An injury to
    these ligaments is sometimes called a sprain.
    The ACL is most often stretched or torn (or both)
    by a sudden twisting motion. The PCL is usually
    injured by a direct impact, such as in an
    automobile accident or football tackle.
  • The medial and lateral collateral ligaments are
    usually injured by a blow to the outer side of
    the knee. This can stretch and tear a ligament.
    These blows frequently occur in sports such as
    football or hockey.

17
tendon injuries and disorders
  • Tendinitis and ruptured tendons Overusing a
    tendon (particularly in some sports). The tendon
    stretches like a worn-out rubber band and becomes
    inflamed.
  • Trying to break a fall. If thigh muscles
    contract, the tendon can tear. This is most
    likely to happen in older people with weak
    tendons.
  • One type of tendinitis of the knee is called
    jumpers knee. In sports that require jumping,
    such as basketball, the tendon can become
    inflamed or can tear.

18
  • Osgood-Schlatter disease caused by stress or
    tension on part of the growth area of the upper
    shin bone. It causes swelling in the knee and
    upper part of the shin bone. It can happen if a
    persons tendon tears away from the bone, taking
    a piece of bone with it. Young people who run and
    jump while playing sports can have this type of
    injury.
  • Iliotibial band syndrome occurs when a tendon
    rubs over the outer bone of the knee causing
    swelling. It happens if the knee is overused for
    a long time. This sometimes occurs in sports
    training.

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