Femur

1
Knee Boney Anatomy
Medial condyle epicondyle Medial
condyle of tibia
Femur Patellar surface femur Lateral condyle
epicondyle Head fibula Tibial
tuberosity Fibula
2
Medial Collateral Ligament
3
MCL Sprain
MCL Mechanism of Injury Valgus Stress

• 1st Degree 2nd Degree
  3rd Degree

4
Valgus Stress Test

• Stresses MCL

Valgus Stress at 0 - 5º
Valgus Stress at 25 - 30 º
5
Lateral Collateral Ligament
LCL-
6
Varus Stress Test
MOI of LCL Injury

• Stresses lateral structures

Varus Stress
Varus Stress at 0 º and 25 º to 30º of flexion
7
Anterior Cruciate Ligament
8
ACL Tear

• Anterior instability
• Mechanism
• Deceleration injury
• IR of femur with knee flexed and foot planted
• Hyperextension of knee

• Swelling
• Pop at time of injury
• Pain with
• AROM
• PROM
• Anterior instability
• Decreased strength
• Giving way or buckling

Signs and Symptoms
9
Anterior Drawer Test
Grading Anterior InstabilityMedial viewRight
knee

• Stabilize Foot
• Check for hamstrings relaxation
• Thumbs either side patellar tendon
• Apply anterior force
• Grade amount of translation

10
Lachmans Test

• Better test than Anterior Drawer
• Takes opposition of hamstrings out of play
• Knee flexed 15 º - 30º
• Stabilize femur
• Apply anterior force to tibia

11
Pivot Shift Test

• Gold standard test for ACL
• Leg is externally rotated
• Valgus force is applied as leg is flexed
• Positive test indicated by clunk sensation

12
Posterior CruciateLigament

• Posterior cruciate

13
Posterior Sag Test

• Posterior Cruciate vs Anterior Cruciate
• Athlete supine
• Both knees flexed 90
• Observe laterally

14
Posterior Drawer Test
PCL
ACL

• Athlete supine
• Knee flexed 90
• Foot neutral
• Sit on foot to stabilize it
• Posterior force applied at tibial plateau
• Positive test indicates PCL injury

15
Medial and Lateral Meniscus

• Medial meniscus C shaped
• Lateral meniscus more circular shaped

• Mechanism of Injury
• Squat with rotation
• Internal rotation of femur
• on fixed tibia

16
Joint Space Orientation
Lateral Meniscus
Medial Meniscus
Medial Joint Space
Lateral Joint Space
17
Mc Murray Test

• Flex knee fully
• Palpate medial lateral joint spaces with one
  hand
• Rotate tibia opposite to femur as knee is
  extended
• Palpable pop and/or pain indicate a positive test

18

• Apleys Compression Test
• External rotation of tibia tests medial meniscus
• Internal rotation of tibia tests lateral meniscus

• Apleys Distraction Test
• Unloads the meniscus
• Stressess MCL and LCL