Ortho
7/9/99
- Defect in subchondral region in apophysis or epiphysis in Osteomyelitis Desecans
- Joint mice—swelling, effusion, crepitus (noise) (deep knee bend),
- Chondromalacia (cartilage softening)
- Patella
- Excessive loading of the joint
- Disuse
- Complicated by obesity
- Valgus or varus variation of the knee
- Different than DJD (patellar femoral )
- Patellofemoral chondrosis
- Histologic dx—scrap tissue off the back of the patella
- PFA arthralgia—doesn't tell you anything
- Climbing stairs and sitting—anterior knee pain
- Common dx
- Almost all cases, when quads are look at, weakness of vastis medialis
- Patellar tracking disorder—up lateral condyle of femur
- Fissuring in articular cartilage
Q line
- ASIS to patella
- 13-18°
valgus –normal for adult
Menisci of the knee
- fxn
- similar to labrum—enlarges concavity for the condyles of the femur
- guide in sagittal motion
- prevent displacement—maintain normal Q angle
- increases contact area b/w tibia and femur
- distribute the load
- medial is more firmly attached—helps it to be injured more easily
- medial collateral ligament and lateral
- unhappy triad
- medial meniscus
- medial collateral ligament
- ACL—anterior cruciate ligament
- External rotation for checking medial meniscus
- Internal rotation for lateral meniscus
- Don't heal very well
- Pain and swelling due to peripheral tissue to the meniscus
- Not pain sensitive in of themselves
- Symptoms
- Effusion (swelling)
- Tenderness around the joint line (through the collateral ligaments)
- Collateral ligament tears at its origin or insertion (from the femur)
- Meniscus pain is right in the center
- Quads atrophy—change in the ability of the knee to fxn
- Joint locking and giving way—caused by damaged meniscus interfering w/normal joint articulations
- Can lead to further injury
- Don't have stability in lower extremity
- Clicking or snapping—femur going over abnormality of the meniscus—usually at 90°
of knee flexion
- fibrocartilagenous
- avascular—poor healing