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Chapter 18
The Knee
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Objectives
• Upon completion of this chapter, you
should be able to:
– Describe the functions of the knee
– Describe the ligament structure of the knee
– Explain the function of the patellofemoral joint
– List and define various sports-related injuries
of the knee
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The Knee
• One of the most complex joints in the body
– Most movements and activities depend on it
for support and mobility
– There is risk of overuse and traumatic injury in
both contact and noncontact sports
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The Knee (cont’d.)
• Two types of cartilage in the knee joint:
– Articular cartilage
– Menisci
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The Knee (cont’d.)
• Ligaments
– Medial collateral ligament (MCL)
– Lateral collateral ligament (LCL)
– Anterior cruciate ligament (ACL)
– Posterior cruciate ligament (PCL)
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The Knee (cont’d.)
• Patellofemoral joint
– Allows knee flexion and extension to occur
with a lesser amount of quadriceps force
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Knee Injuries
• Patellofemoral problems
– Articulation of the patella with the femur
• Symptoms: aching pain in the front or behind the
knee, knee is giving way, crepitus, patellofemoral
joint pain, and mild swelling
• Treatment: correct suspected causes, shoe
inserts, taping and bracing, and stretching
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Knee Injuries (cont’d.)
• Patellar tendonitis
– Inflammation of the patellar tendon
– Caused by high-force, repetitive strain
• Symptoms: anterior knee pain and local
tenderness
• Treatment: activity modification, stretching, ice,
bracing, and taping
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Knee Injuries (cont’d.)
• Fat pad syndrome
– Infrapatellar fat pad is a region of fatty tissue
that lies underneath the patellar tendon
• Symptoms: pain just below the patella, tenderness,
and swelling
• Treatment: special strengthening exercises, taping,
icing, and anti-inflammatory medications
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Knee Injuries (cont’d.)
• Medial collateral ligament (MCL) sprain
– Caused by a blow to the outside of the knee
or a high-energy twisting
• Symptoms: limited motion, swelling of the medial
knee, tenderness, and pain
• Treatment: PRICE, protective wrap, a brace or
crutches, rehabilitation
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Knee Injuries (cont’d.)
• Torn anterior cruciate ligament
– Females are now more susceptible
– Can occur from contact or noncontact causes
• Symptoms: hearing a “pop” followed by effusion,
knee buckling, nausea
• Treatment: splinting, icing, and compressive
wrapping, crutches, reconstructive surgery,
rehabilitation
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Animation - ACL
Click Here to Play ACL Animation
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Knee Injuries (cont’d.)
• Posterior cruciate ligament tear
– Most occur during a fall on the flexed (bent)
knee with the foot plantar flexed or
hyperflexion (bending too far) of the knee
• Symptoms: positive “sag test”
• Treatment: PRICE, physical therapy and
rehabilitation
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Knee Injuries (cont’d.)
• Meniscus tears
– Occur when the knee is twisted suddenly and
one or both menisci become trapped between
the femur and tibia or ligaments in and around
the knee are torn
• Symptoms: slow and mild knee swelling, pain,
popping, locking, or giving way of the knee
• Treatment: compressive wrap, crutches, knee
supports, activity modification, medications, and
physical therapy
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Knee Injuries (cont’d.)
• Epiphyseal (growth-plate) injuries
– Knee is subject to sports-induced trauma at
the centers of bone growth in skeletally
immature athletes
– May alter the length of the affected bone
• Serious injury for a growing athlete
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Knee Injuries (cont’d.)
• Osgood-Schlatter condition
– Group of symptoms involving the tibial
tubercle epiphysis
• Symptoms: pain, swelling, weakness, and a visible
lump
• Treatment: preventing progression, protective
gear, ice, improving flexibility, and stretching
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Knee Injuries (cont’d.)
• Iliotibial band syndrome
– Occurs when there is inflammation of the
iliotibial band
• Irritation usually occurs over the outside of the
knee joint, at the lateral epicondyle
• Treatment: rule out mechanical problems or
training errors, proper footwear, ice, and stretching
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Knee Injuries (cont’d.)
• Fractures
– Result of high-energy trauma
– Vary in location and severity
• Patella fracture is usually the result of direct impact
to the anterior knee
• Distal femoral and proximal tibial fractures may
occur from violent twisting injuries
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Conclusion
• The knee is the largest joint in the body,
and one of the most prone to injury
– Made up of the femur, tibia, and patella
– Also contains large ligaments that help control
motion
• These ligaments connect bones and brace the joint
against abnormal types of motion
• Other parts of the knee, like cartilage, cushion the
joint and help it absorb shock during motion
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