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© Donald Budge 2001
KNEE
LIGAMENTS:
Ligaments attach bone to bone and serve to stabilise the joint. Two COLLATERAL LIGAMENTS support each side of the joint. The MEDIAL COLLATERAL LIGAMENT (inside) is the one most commonly sprained in contact sports such as football. This occurs when the outside of the knee is impacted in a horizontal direction from the side. Depending on the severity, the ANTERIOR CRUCIATE LIGAMENT can also be injured. THE ANTERIOR CRUCIATE LIGAMENT is located in the centre of the knee joint and is responsible for restraining the anterior/posterior (forward/back) movements and twisting of the knee. If the force is strong enough to force the bones apart, the anterior cruciate ligament may tear. The POSTERIOR CRUCIATE LIGAMENT also located in the centre of the knee, can be injured by direct force against the tibia (shin) with the knee bent to 90 degrees. Ligament Sprains (stretches or tears) are graded at three levels. Grade 1: Weakening of fibres with minor tears. Healing in 7-10 days (less with treatment). Grade 2: Stretching and tearing of significant fibres. Healing 2-8 weeks. Exercising too early may result in overstretched ligaments and a "wobbly" knee. Grade 3: Torn ligament which will require suturing.
CARTILAGE INJURIES.
There are two semilunar fibrocartilage MENISCI which partly fill the space between the Femoral and Tibial articulating surfaces. They lie across the joint (medial-inside and Lateral-outside). They stabilize the joint throughout its range, assist with lubrication, serve as "shock absorbers" and contribute to maximum range of movement. The MEDIAL MENISCUS is four times more likely to be injured than the LATERAL because of its position and that it is attached to the MEDIAL COLLATERAL LIGAMENT. MENISCI do not heal due to a lack of blood supply. If torn completely, the torn portion may flip and lead to arthritic problems later. Surgery is generally the only practical treatment. Training can be resumed after 4 to 8 weeks. The cartilage which lines the articulating surfaces of joints is known as HYALINE CARTELAGE if this is damaged or worn, arthritis is likely to result.
CHONDROMALACIA PATELLA
This condition refers to wear and tear on the "inside" aspect of the patella (knee cap). Pain is experienced behind the patella.
BURSITIS.
There are 14 bursae (small fluid filled sacs which provide lubrication between bone and soft tissue). The most common include PREPATELLAR BURSITIS (Housemaid's knee), INFRA-PATELLAR BURSITIS (Clergyman's knee), PES ANSERINUS BURSITIS (Goose foot bursitis) and GASTROCNEMIUS BURSITIS (Baker's Cyst). Treatment will mainly be ice and ultra-sound.
OSGOOD SCHLATTER's DISEASE
Refers to tendinitis of the Patella (knee cap) tendon at its attachment onto the tibia (shin). This condition effects 10-16 year old youths.