Download Knee and Hip

Knee and Hip
Conditions and Injuries
Meniscus Tear
• Etiology: force to the knee
causing translation of the
tibia (any direction), twist
or hyperextension
• S&S: popping, locking or
giving out of the knee,
joint inflammation
• Continued play on a
meniscus tear can lead to
shredding of the cartilagetypically requires surgery
Plica
• Etiology: 20% of the population
fails to create 1 synovial capsule in
the knee from the 3 original-this
left over fold of synovial tissue can
become inflamed during repetitive
knee motions
• S&S pain, clicking, inflammation,
palpable fold or ridge
Patellar tendonitis
(Jumper’s knee)
• Etiology: repetitive resisted knee
extension (jumping, kicking or running).
More common in adolescents because
they are still growing causing pull on the
tendon.
• S&S: pain, inflammation, thickening of
the tendon
• Can lead to rupture but very rare
Osgood Schlaters
(tibial apophysitis)
• Etiology: excessive
pull on a tendon
insertion, in response
the bone overgrows
• S&S: pain, swelling
over insertion site,
possible bony growth
over insertion site
• *if not treated can
cause an avulsion fx
Iliotibial (IT)band friction
syndrome (runners knee)
• Etiology: tightness in the IT band causes it to rub
over the lateral tibial and/or femoral condyle.
More common in women with wider hips.
– Can also cause “snapping hip” or runner’s hip when
it rubs or snaps over the greater trochanter of the
femur
• S&S: pain, popping on lateral knee and or
greater trochanter, inflammation
“True” Knee Dislocation
• Etiology: blow to the
distal leg with foot
planted (blow from any
direction more likely to
see lateral or anterior
tibial translation)
• S&S: obvious deformity,
pain and inability to
move joint
• *Medical emergency
because of arteries and
nerves
Anterior Cruciate Ligament (ACL)
Sprain
• Etiology: Severe
hyperextension, blow
to the lateral knee
with knee slightly bent
(30 degrees)
• S&S pop pain inside
the knee, swelling,
laxity with anterior
stress to the tibia
• 3rd degree sprains
require surgery
Posterior Cruciate Ligament (PCL) Sprain
• Etiology: Fall with full weight on
the anterior tibia, hyperextension or
hard blow to the anterior tibia Not
as common as ACL
• S&S: Feel a “pop,” posterior
translation of the tibia on the
femur, pain and joint inflammation
• 3rd degree sprain require surgery
Lateral Collateral Ligament (LCL) Sprain
• Etiology: blow to the medial
knee or extreme internal rotation
of the tibia. Rare
• S&S: pain and inflammation over
the lateral joint line, varus laxity
Medial Collateral Ligament (MCL) Sprain
• Etiology: blow to the lateral knee,
or severe external twisting
• S&S: inflammation, pain on medial
joint line, medial joint line laxity
with valgus stress
• Typically does not require surgery
because of good vascular supply to
the area
Patellar Dislocation
• Etiology: deceleration with
planting and cutting or blow
to the knee causing the
quadriceps to pull the patella
laterally
• S&S: deformity, inability to
flex knee, pain and muscle
spasm
• Often relocates on its own
Patellar Fracture
• Etiology: direct or indirect trauma (severe pull on
patellar tendon when knee is semi-flexed)
• Signs and Symptoms: extreme inflammation, pain
with movement of the knee
• Complication: 2-3% of the population has bipartite
patella and can mimic patellar fracture
Chondromalacia
(patelofemoral syndrome)
Etiology: softening and
deterioration of the articular
cartilage on the deep
portion of the patella
usually due to repeated
stress, leg posture or
strength deficiencies
• Signs and symptoms: pain
on anterior knee with
activity especially stairs,
deep squats or jumping as
well as inflammation and
edema
Valgus Vs Varus
Hip Anatomy
Hip Dislocation
• Etiology: Rare in sports,
more common in car
accidents. Most common
when the femur is pushed
posterior to the
accetabulum
• S&S: stuck in flexed
abducted position, pain and
deformity
• *medical emergency
because of neurovascular
compromise
Hip Labral Tear
• Etiology: extreme
rotation, planting on a
straight leg
• S&S pain with extreme
ROM, popping or
clicking
• *only treatment is to
tack down or remove
the torn portion
Acute Femoral Fracture
Etiology: more common in
the elderly, direct blow, or
severe twisting
Signs and Symptoms:
significant pain, inability to
stand or walk, possible
shortening of the limb
Management: medical
emergency due to the
vascularization of the area,
often require surgery to
stabilize the area
Special Considerations:
femoral head fractures may
shift (slip) mimicking a hip
dislocation.
Femoral Stress Fracture
• Etiology: more
common in the
femoral neck, more
common in females,
due to repetitive
stress and hip angle
• Signs and Symptoms:
pain during or after
activity that
increases over time,
x-rays may not catch
this type of fracture
• Management: bone
scan or MRI
Ischial Avulsion
• Etiology: sudden
strong contraction of
the hamstrings
(hamstring tendon
pulls a portion of the
ischial tuberosity off)
• Signs and Symptoms:
pain with active hip
extension/knee
flexion, pain when
sitting on hard
surfaces
• Management: X-ray
to confirm fracture
Sacroiliac sprain
• Etiology: repetitive
hyperextension of the hip,
torsion, prolonged hip and
lumbar flexion
• S&S: pain or SI joint, pain with
hyperextension or terminal
flexion of the hip. May be
associated with a true or false
leg length descrepancy
• Over time may cause
inflammation of the sciatic
nerve causing radiating pain
down the leg and possible
muscle weakness
Broken Tail Bone
AKA Coccyx Fracture
• Etiology: Fracture of the coccyx due
to fall in a seated position, direct
blow, or in child birth
• S&S: pain especially when sitting or
with direct pressure
Ricketts
• Softening of the bones due
to decreased Vitamin D,
Calcium, and/or
Phosphorus
• Usually the result of
malnutrition or famine
•