THE KNEE IS SUSCEPTIBLE TO TRAUMATIC INJURY DUE TO ITS LOCATION AT THE
ENDS OF TWO LONG LEVER ARMS.(TIBIA &FEMUR)
THE KNEE JOINT DEPENDS ON THE LIGAMENTS AND MUSCLES THAT SURROUND IT FOR
ITS STRENGTH AND STABILITY
THE KNEE DOES NOT DEPEND ON ITS BONY CONFIGURATION FOR STABILITY.
THE TIBIOFEMORAL JOINT IS THE LARGEST JOINT IN THE BODY.
THE TIBIOFEMORAL JOINT IS A MODIFIED HINGE JOINT.
THE SYNOVIUM AROUND THE KNEE JOINT IS EXTENSIVE AND DOES COMMUNICATE WITH
THE MANY BURSAES IN AND AROUND THE KNEE.
CRUCIATE MEANS: LIGAMENTS THAT CROSS EACH OTHER.
THE SPACE BETWEEN THE TIBIA AND FEMUR IS PARTIALLY FILLED WITH MENISCI.
THE MEDIAL MENISCUS IS C SHAPED WHILE THE LATERAL MENISCUS IS MORE O SHAPED.
BOTH MENISCI ARE THICKER AT THE PERIPHERY WHILE THINNER ON THEIR INNER
MARGIN.
THE MENISCI ARE AVASCULAR IN THEIR INNER 2/3 BUT SLIGHTLY VASCULAR IN THE
OUTER THIRD.
MENISCI ARE HELD IN PLACE VIA THE CORONARY LIGAMENT TO THE TIBIA.
MENICSAL FUNCTION INCLUDES: LUBRICATION AND NUTRITION OF THE JOINT, AND
WILL SHOCK ABSORBER TO THE JOINT.
THEN MENISCI REDUCE FRICTION DURING MOVEMENT AND AID THE LIGAMENTS AND
CAPSULE IN PREVENTING HYPEREXTENSION OF THE KNEE JOINT.
MENISCI POSSES NO NERVES. THEREFORE THERE IS NO PAIN WHEN THEY ARE INJURED
UNLESS THE CORONARY LIGAMENT IS DAMAGED AS WELL.
SINCE THE MENISCI ARE BASICALLY AVASCULAR TOO THERE IS USUALLY NO BLOODY
EFFUSION INTO THE KNEE JOINT EITHER.
IT IS BECAUSE OF THE LACK OF VASCULARITY THAT HEALING OF THE MENISCI IS
QUITE POOR.
THE LATERAL MENISCUS IS LESS FIRMLY ATTACHED TO THE TIBIA THUS IT IS LESS
PRONE TO INJURY.
THE PATELLOFEMORAL JOINT IS A MODIFIED PLANE JOINT.
THE LATERAL ARTICULAR SURFACE OF THE PATELLA IS WIDER.
THE PATELLA CONTAINS THE THICKEST LAYER OF CARTILAGE IN THE BODY.
THE KNEE IS BASICALLY 3 JOINTS:
TIBIA/FIBULA
PATELLA/FEMORAL
FEMORAL/TIBIAL JTS.
TERRIBLE TRIAD INJURY A.K.A. O’DONOGHUE INJURY: DAMAGE TO
THE MEDIAL MENISCUS, MEDIAL COLLATERAL LIGAMENT AND THE ANTERIOR CRUCIATE
LIGAMENT.
MOST COMMON TEAR IN A MENISCUS IS A BUCKET HANDLE TEAR..
OSGOOD SCHLATER DISEASE: AVASCULAR NECROSIS OF THE TIBIA
TUBERCLE.
OSTEOCHONDRITIS DESSICANS(JOINT MICE) ARE USUALLY FOUND IN THE AREA OF
THE MEDIAL CONDYLE.
SYNDIG -LARSEN DISEASE: AVASCULAR NECROSIS
OF THE SUPERIOR AND INFERIOR POLES OF THE PATELLA.
BLOUNTS DISEASE: AVASCULAR NECROSIS OF THE MEDIAL TIBIAL
EPIPHYSIS.
JUMPERS KNEE: INJURY TO THE INFERIOR POLE OF THE PATELLA.
1% POPULATION HAVE BIPARTATE OR TRIPARTATE PATELLA. THESE ARE USUALLY BILATERALL
IN APPEARANCE AS WELL.
PATELLA WILL TRACK LATERALLY DUE TO VASTUS MEDIALIS WEAKNESS.
GENU= MEANS KNEE RELATED.
GENUVALGUM: LOWER LEG IS LISTING AWAY FROM THE MIDLINE: SEEN IN RICKETS
AND HYPERPRONATION OF THE ANKLE. BRINGING THE KNEES TOGETHER TILL THEY
TOUCH, THERE IS A 9-10CM SPACE AT THE MALLEOLI = CLASSIC GENUVALGUM.
GENUVARUM: (BOWLEGGED): ALWAYS NOTED IN FANTS AND IS CONSIDERED NORMAL
TILL AGE 3.
GENURECURVATUM: (BACK KNEE). KNEE IS POSTERIOR TO THE PLUMB LINE
INTERNAL TIBIA TORSION: MEDIAL MALLEOLUS IS FOUND MORE POSTERIOR TO THE
LATERAL MALLEOLUS.
TIBIAL VARUM: USUALLY SECONDARY TO BLOUNTS DISEASE. THE TIBIA BOWS WITH
THE CHILD HAVING A WADDLING LIMP.
MENISCI ARE ATTACHED TO THE TIBIA BUT NOT THE FEMUR.
THERE ARE 11 BURSAE AROUND THE KNEE: 4 ANTERIORLY, 4 LATERALLY AND 3 MEDIALLY.
THE PES ANSERINE: IS A CONJOINED TENDON MADE UP OF SARTORIUS, GRACILIS
AND SEMITENDONOSIS.
THE PES ANSERINE IS THE MEDIAL INSERTION FOR THE OUTER HAMSTRING GROUP.
THE PES ANSERINE IS SEPERATED FROM THE UNDERLYING FEMORAL CONDYLE BY A
BURSA.
Q-ANGLE IS NORMALLY 10-13 DEGREES IN MALES AND 10-15 DEGREES IN FEMALE.
INCREASE IN THE NUMBER INDICATES A LATERAL TRACKING OF THE PATELLA.
HOFFA’S DISEASE: INFRAPATELLA FAT PAD INFLAMMATION.
ILIOTIBIAL BAND INSERT INTO GERTY’S TUBERCLE WHICH IS ON
THE LATERAL TIBIA.
PELEGRINI STEADE DISEASE: A.K.A. MILKMAIDS KNEE. INJURY OVER THE MEDIAL
FEMORAL CONDYLE WITH A HEMATOMA THAT OSSIFIES.
IN HYPEREXTENSION INJURY OF THE KNEE YOU DAMAGE THE ANTERIOR CRUCIATE LIGAMENT.