Knee

Question 1

what is the anatomy of the knee?

Answer 1

tibio femoral and patelo femoral joints

patellofemoral joint

• sesamoid within the quad tendon inserting into the tib tubercle
• stabilised by medial and lateral retinacula

Ligaments

• ACL, post-sup from anterior tibial plateau to posterolateral aspect of intercylar notch
• PCL, ant-sup posterior tibial plateau to medal aspect of intercondylar notch

ACL prevents tibia moving forwards and control rotation motion, PCL prevents femur from sliding forward on the tibia

• MCL, medial condyle femur to aneriomedial asp of tibia and medial meniscus, broad band, injured via valgus stress
• LCL, lateral border of femur to head of fibula, cord like , rarely injured

Menisci

• medial and lateral attach to the tibial plateau
• absorb shock and protect cartilage and aid in stabilization, lubrication and nutrition of the knee

Question 2

what is the motion that occurs within the knee?

Answer 2

• primarily flexion and extension in SP, some TP motion, FP motion in pathological
• ROM 0 ext and 140 flexion
• TP motion screw home the knee in extention, caused by medial rotation of the femur into the larger medial condyle, stabilising the knee and tightening the collaterals
• popliteus external rotates the knee to unlock it

Question 3

What is the motion in gait of the knee?

Answer 3

• Flexes at heel strike to absorb shock
• extends from Ffoot loading to lift body allow swing
• Flexes after heel lift to increase propulsion power
• Flexed until ground clearance and before extension at heel strike

Question 4

What are the factors of PFPS?

Answer 4

• Large Q angle, ASIS to patella, Patella to tib tubercle
• Varus knee alignment
• altered patella placement, trochlea anatomy
• VMO weakness/activation
• xs hip adduction and internal rotation (f>m)
• Foot pronation

Question 5

Name the multifactorial condition by christian bartons PDPS aetiologies?

Answer 5

• loss of trunk and pelvic control
• patellar mal tracking, inc PFJ stress
• hip muscle function deficits + inc hip add and IR
• quadriceps weakness + delayed VMO activation
• increase foot mobility

Question 6

what does witvrouws say?

Answer 6

refer to lecture notes

Question 7

How may excess foot pronation cause PFPS?

Answer 7

-ex foot prontation increase medial tibial rotation when the leg should be externally rotated, which leads to femoral intern rotation and lateral tracking of patella

Question 8

What is iliotibial band syndrome?

Answer 8

• iliotibial band runs from upper thigh to insert into the lat tibial tubercle. it passes over the lateral femoral condyle with extension and flexion
• rotational issues are believed to be a common contributing factor which may be influenced via orthoses

Question 9

What are common factors of ACL injury?

Answer 9

• sporting injury
• valgus knee pos with degree of tibial rotation when non contact injury
• control of foot position to decrease rotation of the tibia may be of benefit if a factor

Question 10

Lower back pain?

Answer 10

• multifactorial area must be interdisciplinary fashion
• podiatry can help compendsate LLD
• cavus rigid foot may trasnfer GRF to lower back, orthoses to help shock absorption
• sagittal plan blockade, increase forward lean, inc erector spinae contracture therby inc pain, orthoses reccomended