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Knee Injuries. Knee Anatomy. Bones Femur, Tibia, Patella Ligaments Anterior Cruciate Ligament (ACL) Posterior Cruciate Ligament (PCL ) Cruciate = Crossing Medial Collateral Ligament (MCL) Lateral Collateral Ligament (LCL ) Collateral = support / at the side Meniscus
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Knee Anatomy Bones Femur, Tibia, Patella Ligaments Anterior Cruciate Ligament (ACL) Posterior Cruciate Ligament (PCL) Cruciate = Crossing Medial Collateral Ligament (MCL) Lateral Collateral Ligament (LCL) Collateral = support / at the side Meniscus Medial and lateral Meniscus
MCL Tear Valgus forces Swelling over the medial joint line Decrease in ROM Grade 2 or higher should be placed in a straight leg immobilizer with crutches Typically does not require surgery for repair
http://www.sportsmd.com/SportsMD_WatchVideo/vid/313.aspx http://www.youtube.com/watch?v=j_Mdm4v-ty8&feature=results_video&playnext=1&list=PLDD2266210072D934 http://www.youtube.com/watch?v=wPSXIltT0Bs (MUTE)
LCL sprain Rare injury Very awkward mechanism Varus force the angle pointing away from the midline Force from the medial side of knee No surgery RG III http://espn.go.com/nfl/story/_/id/8729737/robert-griffin-iii-washington-redskins-does-not-major-knee-injury
PCL sprain Very rare May not need to be repaired Strongest but least important ligament in the knee Hyperflexion Often occurs when falling with a bent knee Common in car accidents when the knee hits the dashboard Posterior Drawer Test
http://www.youtube.com/watch?v=lpIOMuqXWrE&feature=related ACL sprain Contact or non-contact Usually considered a “cutting” injury “pop” with immediate dysfunction Usually associated with meniscus injury 95% of cases require some surgery for return to sports 6 to 8 month rehabilitation Autograft vs. Allograft http://www.youtube.com/watch?v=QrvHzaDxBug&feature=related
Meniscus “cartilage” Shock absorbers Increase joint congruency Increase joint stability Injury Mechanism Rotation Extreme knee flexion
Knee Rehabilitation Decrease swelling/ecchymosis/pain Increase ROM Increase strength Within 85% of the uninvolved leg Increase weight bearing Increase function Return to partial activity Return to full activity
PCL • Posterior Drawer • Meniscus • McMurray Test • Bounce Home • Patellofemoral Tests Special Tests for the Knee ACL Lachmans Anterior Drawer Pivot-shift MCL Valgus Stress Test LCL Varus Stress Test
What happens if you need a knew knee? • Knee Replacement Surgery
Knee Injuries • Rugby is dangerous to the knees. • Basketball Dislocation. • The U. • Houston’s football team is terrible.