6. Knee Problems Flashcards
what must always be examined along with the knee
the hip
extensor mechanism problems
common in teens as body weight inc and sporting activities inc
patellar tendonitis can occur which is self limiting and requires rest and possibly physio
apophysitis
inflammation of a growing tubercule where tendon attaches
occurs at either end of patellar tendon due to repetitive strain
apophysitis - tibial tubercule
Osgood-Schlatter disease
more common
apophysitis - inf pole of patella
Sinding-Larsen-Johanssen disease
course of apophysitis
self limiting
patient may be left with bony prominence
anterior knee pain
common in teens - patellofemoral dysfunction
there may be softening of the hyaline cartilage of the patella - chondromalacia patella
predisposed to by ligamentous laxity, muscle imbalance and genus valgus
what is the cause of patellofemoral dysfunction
unclear
muscle imbalance, ligamentous laxity, subtle skeletal predisposition
patellar instability
dislocation and subluxation of the patella is common in teens and may be related to trauma with a tear in the medial patellofemoral ligament
predisposed to by ligamentous laxity and variations in bony anatomy
what can dislocation of patella cause
fragments of hyaline cartilge/subchondral bone to break off
removed by arthroscopic surgery
what does one dislocation predispose you to
another
pateints may stabilise as they grow older and with physio
what may recurrent dislocation require
surgery to correct any bone predisposition or reconstruct medial patellofemoral ligament
osteochondritis dissecans
subchondral bone becomes avascular and may progress to fragments of bone and overlying cartilage breaking away from the bone to cause loose bodies
what does OD predipose one to
OA
where does OD most commonly affect
knee - lateral side of medial femoral condyle
how do patients with OD present
poorly localised pain after exercise, effusion and occasionally locking
meniscal problems
occur in kids and teens
mainly bucket handle or peripheral tears
abnormal menisci
some patient have an circular rather than C shaped miniscus
usually the lateral one
can be a source of pain and popping sensation
arhtroscopic partial meniscectomy may help
