Knee Joint Complex PDF

Knee joint complex 1. Anatomic considerations - Intermediate joint of the lower limb. - Condylar joint — femoral condyles (convex) and tibial glenoids (concave) - Single degree of freedom + accessory movement - Femoro-patellar + femoro-tibial jo...

Knee joint complex 1. Anatomic considerations - Intermediate joint of the lower limb. - Condylar joint — femoral condyles (convex) and tibial glenoids (concave) - Single degree of freedom + accessory movement - Femoro-patellar + femoro-tibial joints - Femoro-patellar — patella + femoral trochlea (with pre patellar cartilage) - Menisci: fibrocartilage — compression transmitters 2. Range of motion - FLEXION: - Active flexion with extended hip: 120º - Active flexion with flexed hip: 140º - Passive flexion with extended hip: ¿? - Passive flexion with flexed hip: 160º - EXTENSION: - Active: 0º - Passive: 0º - INTERNAL ROTATION: 30º - EXTERNAL ROTATION: 60º 3. Main knee muscles - QUADRICEPS: extension - SARTORIUS: flexion and internal rotation - HAMSTRINGS: - Semitendinosus: flexion and internal rotation - Semimembranosus: flexion and internal rotation - Femoral biceps: flexion and external rotation - POPLITEAL: flexion and internal rotation 4. Tests LUNGE TEST: - Performance: patient standing and we ask him to do a lunge - Outcome: valgus collapse — internal rotation and adduction of hip + knee valgus + external tibial torsion + prone foot - Clinical significance: hypoactivity of hip separators with hyperactivity of the approximators. In addition, hypoactivity of knee internal rotators and hyperactivity of knee external rotators. SQUAT TEST: - Performance: patient standing and we ask him to do a squat - Outcome: “bat wing” — during the descendent there comes a point where a posterior pelvic bascule is produced - Clinical significance: tension in hamstrings VASTUS MEDIALIS AND ADDUCTOR MAGNUS CO-CONTRACTION TEST: - Performance: patient in supine position and we place a ball between his knees. We ask him to do a knee extension at the same time that he press the ball - Outcome: low contraction in one of the two muscle or excessive tremor - Clinical significance: hypotonia in vastus medialis MONOPODAL SUPPORT TEST WITH FITBALL: - Performance: patient standing and we place a fitball between his body and the wall. We ask him to keep monopodal support with the leg away from the wall - Outcome: spring extension of the supported knee - Clinical significance: compensation to cover hypotonia of vastus medialis ANTEROMEDIAL LUNGE: - Performance: patient standing and we ask him to do a lunge directed medially - Outcome: number of repetitions in 30 seconds, and internal rotation of the hip - Clinical significance: weakness of separators and external rotators of the hip BALANCE SIT AND REACH: - Performance: patient standing with monopodal support and we ask him to touch the opposite heel to the ground well in front of the supported foot. - Outcome: number of repetitions in 30 seconds, and instability - Clinical significance: weakness of gluteus medius and vastus medialis