Download Knee Problems

Knee Problems
By Billy Wilson
Chondromalacia
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Chondromalacia is due to an irritation to the
undersurface of the kneecap.
The undersurface is covered with a smooth layer of
cartilage that normally glides across the knee effortlessly
during bending of the joint. Chondromalacia occurs
when the kneecap rubs against one side of the knee joint
and causes an irritation in the cartilage.
Abnormal patellar tracking pulls the kneecap toward one
side of the femur instead of pulling it in a straight line.
Chondromalacia
Chondromalacia
It is the most common cause or chronic
knee pain
 It is also sometimes called “housemaid’s
knee”, “secretary’s knee”, or “runner’s
knee”
 Women are more commonly affected
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Symptoms and Treatment
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Symptoms
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Discomfort of the inner knee area
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Aggravated by activity
Aggravated by prolonged sitting
Tightness in knee area
Loss of quadriceps muscle strength
Mild swelling
Treatment
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NSAIDs and Ice for pain management
Avoid motions that irritate the knee
Rehabilitation focuses on the stretching and strengthening of the
quadriceps and hamstring muscle groups
 Possible surgery
Iliotibial Band Friction Syndrome
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The iliotibial band is the superficial thickening of tissue
on the outside of the thigh, extending from the outside of
the pelvis, over the hip and knee, and inserting just
below the knee
It is crucial to stabilizing the knee during running, moving
from behind the femur to the front during the gait cycle
Continual rubbing of the band over the lateral femoral
epicondyle may cause the area to become inflamed or
the band itself may suffer irritation
Can also occur where IT band connects at hip, but this is
less likely as a sports injury
Iliotibial Band Friction Syndrome
Ober’s Test
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Patient laying on side with
unaffected side down with
unaffected knee and hip at 90
degrees
Examiner stabilizes the pelvis,
then abducts and extends the
affected leg until in line with
rest of body
Affected leg then lowed into
adduction
If band is tight leg will remain
in abduction and pain will be
experienced in lateral portion
of knee
Symptoms and Treatment
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Symptoms
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Pain to outside of knee or hip
Local tenderness and inflammation
Dull pain during run or sharp pain while running downhill
Treatment
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RICE
NSAIDs
Stretching the IT Band
Ultrasound
Deep-tissue massage
Local steroid injection
Meniscus Tear
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Results when the knee is weight bearing and
experiences a rotational force while extending or
flexing
Also caused by degenerative processes seen in
older patients
Menisci are made of tough cartilage
There are two menisci in our knee; each rests
between the femur and the tibia
Medial meniscus is more likely to be injured than
the lateral meniscus
Meniscus Tear
Symptoms and Treatment
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Symptoms
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Effusion developing over 48-72 hours
Joint line pain
Loss of motion
Intermittent locking and giving away
Pain with squatting
If chronic: recurrent swelling, obvious muscle atrophy around knee, knee
collapsing, popping sensation
Treatment
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RICE
Many people do nothing for their meniscus tear because they see no symptoms
and it doesn’t interfere with activity
 Surgery
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Meniscus repair
Meniscectomy
Meniscus Injuries
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Other types of meniscus injuries:
 Longitudinal
tear- a tear that occurs along the length
of the meniscus
 Bucket-handle tears- an exaggerated form of a
longitudinal tear where a portion of the meniscus
becomes detached from the tibia forming a flap that
looks like a bucket handle
 Degeneration- frayed edge on the meniscus
 Radial tear- tear across the radius of the meniscus