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    Functional Pathology: Should Be Applied With The Knee First in 30 Degrees of Flexion and Then in Full Extension

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    Fita
    Unstable knee ligaments can result in abnormal movement of the tibia including tilting, gliding, and rotating in different directions. Testing involves applying stress to the knee in different positions to assess medial and lateral stability. More commonly, the ACL, lateral capsule, and LCL are all torn, resulting in anterior drawer and lateral subluxation of the tibia when it rotates around the stable medial condyles. MRI is useful for imaging torn ligaments like the ACL and MCL. Conservative treatment involves physical therapy while surgical indications include recurrent locking, instability, or ligament injuries in young patients. Surgery treats injuries to the MCL, lateral and rotatory instability, isolated PCL injuries, and isolated or combined

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    Functional Pathology: Should Be Applied With The Knee First in 30 Degrees of Flexion and Then in Full Extension

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    Fita
    20 views6 pages
    Unstable knee ligaments can result in abnormal movement of the tibia including tilting, gliding, and rotating in different directions. Testing involves applying stress to the knee in different positions to assess medial and lateral stability. More commonly, the ACL, lateral capsule, and LCL are all torn, resulting in anterior drawer and lateral subluxation of the tibia when it rotates around the stable medial condyles. MRI is useful for imaging torn ligaments like the ACL and MCL. Conservative treatment involves physical therapy while surgical indications include recurrent locking, instability, or ligament injuries in young patients. Surgery treats injuries to the MCL, lateral and rotatory instability, isolated PCL injuries, and isolated or combined

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    knee

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    Knee

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    Unstable knee ligaments can result in abnormal movement of the tibia including tilting, gliding, and rotating in different directions. Testing involves applying stress to the knee in different positions to assess medial and lateral stability. More commonly, the ACL, lateral capsule, and LCL are all torn, resulting in anterior drawer and lateral subluxation of the tibia when it rotates around the stable medial condyles. MRI is useful for imaging torn ligaments like the ACL and MCL. Conservative treatment involves physical therapy while surgical indications include recurrent locking, instability, or ligament injuries in young patients. Surgery treats injuries to the MCL, lateral and rotatory instability, isolated PCL injuries, and isolated or combined

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    20 views6 pages

    Functional Pathology: Should Be Applied With The Knee First in 30 Degrees of Flexion and Then in Full Extension

    Uploaded by

    Fita
    Unstable knee ligaments can result in abnormal movement of the tibia including tilting, gliding, and rotating in different directions. Testing involves applying stress to the knee in different positions to assess medial and lateral stability. More commonly, the ACL, lateral capsule, and LCL are all torn, resulting in anterior drawer and lateral subluxation of the tibia when it rotates around the stable medial condyles. MRI is useful for imaging torn ligaments like the ACL and MCL. Conservative treatment involves physical therapy while surgical indications include recurrent locking, instability, or ligament injuries in young patients. Surgery treats injuries to the MCL, lateral and rotatory instability, isolated PCL injuries, and isolated or combined

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    Functional pathology

    Unstable tibiofemoral relationships may result in : abnormal sideways


    tilt (varus or valgus), excessive glide (forwards, backwards or even in
    an oblique direction), unnatural rotation (internal or external), or
    combinations of these.
    When testing for medial and lateral stability, valgus and varus stresses
    should be applied with the knee first in 30 degrees of flexion and then
    in full extension.
    More commonly there is anterolateral rotatory instability where, in
    addition to a torn ACL, the lateral capsule and LCL are torn or
    stretched. In this instance, not only will the anterior drawer test be
    positive, but the lateral tibial condyle can be made to sublux forwards
    as the tibia rotates abnormally around an axis through the medial
    condyles; this is the basis of the pivot shift phenomenon
    Chronic deficiency of the arcuate ligament complex causes a type of
    postero-lateral rotatory instability that is a counterpart of the pivot
    shift phenomenon. Complete tears of all the posterior structures also
    allow the knee to hyperextend.
    Imaging
    MRI

    Torn knee ligaments MRI (a) Coronal T2- weighted image showing a
    medial collateral ligament tear with surrounding oedema and joint
    effusion. (b) Sagittal T2-weighted image showing an intrasubstance tear
    of the anterior cruciate ligament with a large joint effusion.
    Therapy
    Approach for conservative should always be a supervised, disciplined and
    progressively vigorous exercise programme to strengthen the quadriceps and the
    hamstrings. At the end of 6 months the patient should be reexamined.

    Indications for operation :


    Recurrent locking
    Intolerable symptoms of giving way;
    suboptimal function
    ligament injuries in adolescents
    Operation treatment for :

    Medial collateral ligament Combined injuries


    - anterolateral or anteromedial
    insufficiency
    rotatory instability
    Isolated lateral instability - Indication for PCL
    reconstruction in patients
    Isolated PCL insufficiency who have more than 1015
    mm of posterior tibial
    Isolated ACL insufficiency
    translation in the drawer test.
    Partial tears of the anterior cruciate ligament are more
    problematic and there is still much controversy about the need for
    surgery in these cases. The decision should be based on an
    assessment of the patients symptoms and functional capacity
    rather than the appearance of the ligament.

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