THE KNEE
-Not a hinge!
Flexion by gliding and rolling of condyles on tibia plus rotation through cruciates
-menisci cushion, vascular with poor healing -muscles help support joint.
CONGENITAL
Dislocation
Discoid Meniscus
DEVELOPMENTAL
-Recurrent dislocation of the patella
-dislocates laterally often post-traumatic, then easily. Knee may lock in flexion. Apprehension test. Transplant patella tendon medially/release proximal muscle
Genu valgum
-resolves usually, operative correction later
Tibia vara
-bow leg deformity, surgical correction
Osgood-Schlatter disease
-common, usually adolescent boys. Tibial tubercle epiphysis swollen. Pain and tenderness localised to tubercle possibly swelling. Usually settles spontaneously; rest or operation
Pseudoarthrosis of the tibia
-cystic defect in lower third of tibia causing bowing, fracture results with poor healing. Graft, plaster.
TRAUMA
Patella dislocation Ligamentous injuries Patella fracture Tendon ruptures Tibial fractures Meniscus lesions
-tears, usually medial, twisting. Swelling, locking, usually settles with recurrence. Orthopaedic investigation, remove torn element
-cysts, cause pain
INFECTIONS
Acute. Osteomyelitis in children. Suppurative arthritis (esp if steroids/neonates). Young adults gonorrhoeal. Chronic. TB causes pain swelling and wasting
NEOPLASTIC
Metastatic Primary. Usually painful, and include joint
METABOLIC
Usually with other joints, Pagets, scurvy, rickets
DEGENERATIVE
Popliteal Cysts. Common. Usually asymptomatic. Bakers cyst secondary to RA and may infiltrate calf muscle
OA. Common joint. Pain, limp, reduced rom, angulation, effusion, inflammation, unstable, osteophytes. Weight loss, stick support, analgesia, physio. Surgery.
RHEUMATOID
RA. Pain stiffness, synovial thickening, effusion, joint destruction
OTHER ARTHRITIC CONDITIONS
Ankylosing Spondylitis
Gout
Foreign Bodies, cartilage, bone, soft tissue. Operate.
Course Organisers
| Chris Wilkinson, Steve Walter & Gilly Cooper |
| email Chris Wilkinson |
| email Steve Walter |
| email Gilly Cooper |
web designed by Chris Wilkinson, North Worcestershire VTS