The Knee

Question 1

Osgood-schlatter lesion ?

Answer 1

• Traction-induced inflammation of the insertion fo the patella tendon (traction apophysitis)
• happens before skeletal maturity
• a bump forms because the separated growth plates keep growing and expanding

Question 2

How to test patella Baja vs patella Alta ?

X-ray

Answer 2

Size of patella (A)
Size of space between tuberosity and base of patella (B)

If B is bigger = patella Alta
If A is bigger = patella baja

Question 3

What femoral epicondyle is bigger why?

Answer 3

Medial - more muscle attachments

Question 4

What is chondromalacia patella?

Answer 4

Acute injury to the patella or chronic friction between the patella and the femur can result in the start of PFPS

Question 5

What kind of joint is proximal fibular tibial joint?

What movement ?

Answer 5

Plane joint
S-I
I-S

Question 6

What type of joint is Tibiofemoral joint ?

What Movement?

Answer 6

Plane joint (specialized hinge) 
Flexion extension (minimal shearing)

Question 7

What is the unhappy triad ? Why?

Answer 7

Medial meniscus
ACL
MCL

All prone to injury

Question 8

What does ACL do?

What does PCL do ?

Answer 8

Prevents posterior rolling

Prevents anterior rolling

Question 9

Closed/open packed position of knee?

Answer 9

Closed:
-full extension with full external rotation

Open:
-25* flexion

Question 10

Capsular pattern of knee?

Answer 10

Flexion

Extension

Question 11

What is the Q angle?

Answer 11

Carrying angel of knee:
Line through
Middle patella -> ASIS
Middle of tibial tuberosity -> through middle patella

Find angle

Q angle = 10-15*

Question 12

Rang of motion of knee ?

Answer 12

Flexion 135*
Extension 0-15*
Internal rotation 10*
External rotation 10*

Question 13

What do you look for in gait?

Answer 13

Limping, walking with knee bent, weight bearing ?

Question 14

Area specific observation?

Answer 14

Enlargement of the tibial tubercle, swelling in bursar, bakers cyst (back of leg)

Question 15

Static bony palpation of knee?

Answer 15

-patella
-Tibial tuberosity
Medial aspect:
-medial tibial plateau
-tibial condyle
-medial femoral condyle
-adductor tubercle
Lateral aspect:
-lateral tibial plateau
-lateral tibial condyle
-lateral femoral epicondyle
-lateral femoral condyle
Head of fibula

Question 16

Static soft tissue palpation ?

Answer 16

Anterior:
-quads
-infrapatellar tendon
-regions of bursa(supra, pre, infra 
Medial:
-medial meniscus 
-medial collateral lig region
-Sartorius, gracilis, semitendinosus
-pes anserinus bursa (separates ^)
Lateral aspect 
-lateral meniscus 
-lateral collateral ligament 
-Biceps Femoris tendon
-iliotibial tract (fascia)
-common perineal nerve 
Posterior:
-Popliteal fossa (post tibial nerve, popliteal vein, popliteal artery) 
-location of bakers cyst

Question 17

Joint play

Answer 17

Tibiofemoral

• P-A/A-P glide
• P-A/A-P glide with internal
• P-A/A-P with external
• M-L/L-M

Patellofemoral
-I-S/S-I glide

Tibiofibular
A-P/P-A sheer
I-S/S-I glide (inversion/ eversion of foot)