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Anatomy and Common Injuries of the Knee

Anatomy and Common Injuries of the Knee. Kimberly Clement RN-C, MSN, MBA Assistant Professor of Nursing Saint Joseph’s College of Maine. Components of the Knee. Bones Patella Femur Tibia Fibula. Ligaments A band of flexible fibrous connective tissue that connects

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Anatomy and Common Injuries of the Knee

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  1. Anatomy and Common Injuries of the Knee Kimberly Clement RN-C, MSN, MBA Assistant Professor of Nursing Saint Joseph’s College of Maine

  2. Components of the Knee • Bones • Patella • Femur • Tibia • Fibula

  3. Ligaments • A band of flexible fibrous connective tissue that connects two bones or cartilages to hold together a joint.

  4. Tendons • A flexible but inelastic cord of fibrous collagen connecting a muscle to a bone

  5. Cartilage • Firm rubbery tissue that cushions bones at joints.

  6. Synovial Fluid • A fluid whose main function is to act as a lubricant in the joint • Bursa • A fluid filled sac containing lubricating fluid that decreases friction between a tendon and a bone.

  7. Knee Arthroplasty • Knee replacement surgery is the replacement of diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee. Total Knee Replacement Partial Knee Replacement

  8. Total Knee Replacement Surgery http://www.youtube.com/watch?v=WvlJ-1XHudA

  9. Meniscus Injury • Most meniscal injuries are treated in an outpatient setting • Patients are encouraged to maintain joint Immobilization and weight bear as tolerated for a few days. • Use of anti-inflammatory medications and cortisone injections may also be helpful. • After acute pain has decreased, physical therapy can be helpful in helping the patient to regain strength and range of motion.

  10. Surgical Repair of a Meniscal Injury • Partial Meniscectomy • Removal of the torn meniscus • Meniscus Repair • Procedure done to place the edges of the tear together with sutures or tacks. • For this to be successful the tear must occur on the outer edge of the meniscus where there is good blood supply necessary for healing.

  11. Arthroscopic View of the Meniscus A: Normal Meniscus B: Torn Meniscus C: Surgically repaired

  12. Arthroscopic Knee Surgery Meniscectomy vs. Meniscus Repair • http://www.youtube.com/watch?v=kB98kPLOcBM

  13. Sprains vs. Strains • Sprain • An injury to the ligaments of a joint. • Strain • An injury to muscle or tendon tissue.

  14. Determining the Degree of InjuryAccording to the ICD-9-CM • A first-degree injury stretches the ligament or muscle tendon unit, but does not cause significant structural damage or weakness. • First-degree sprains are characterized by minimal swelling (edema), localized pain and tenderness, and no marked instability. • The individual with first-degree sprains may perform activities within the limits of pain tolerance without causing further damage to the knee.

  15. A second-degree injury partially disrupts and weakens the ligament or muscle tendon unit. • Second-degree sprains are characterized by partial tears, moderately localized pain and tenderness, and mild instability. • The injured structure must be protected from stress for a period of about 6 weeks in order to prevent further injury.

  16. A third-degree injury is one in which the ligament or muscle tendon unit is completely disrupted. • Third-degree sprains exhibit complete tears, mild to pronounced edema, and clear instability. • Third degree damage requires a long period of protection from stress and often surgical repair

  17. Ligaments

  18. Anterior Cruciate Ligament Injury

  19. ACL Reconstruction Surgery • A graft is used to replace the ligament. • Autograft • Taken from a patellar tendon or a hamstring tendon • Allograft • Tissue that is taken from a deceased donor

  20. ACL Repair Surgery • Generally only used with an avulsion fracture (a separation of the ligament and a piece of the bone from the rest of the bone). • In this case, the bone fragment connected to the ACL is reattached to the bone

  21. Anterior Cruciate Ligament (ACL) Reconstruction Animation • http://www.youtube.com/watch?feature=player_detailpage&v=q96M0jRqn7k

  22. Please feel free to ask any questions you may have. Thank you!

  23. References Carpenito, L. Nursing Diagnosis: Application to Clinical Practice, J.B. Lippincott Company. Lewis, S., Collier, I., Heitkemper, M. (2011) Medical Surgical Nursing (8thEdition). St. Louis: Mosby. Melnyk, B. & Fineout-Overholt, E. (2004) Evidence-Based Practice in Nursing & Healthcare. Hagerstown: J. B. Lippincott Company. Siedel, H., Ball, J., Dains, J., & Benedict, G. (2011) Mosby’s Guide to Physical Examination. St. Louis: Mosby.

  24. http://orthoinfo.aaos.org/topic.cfm?topic=a00358 http://www.ncbi.nlm.nih.gov/pubmed/3311520 http://www.nlm.nih.gov/medlineplus/ency/article/002970.htm http://orthoinfo.aaos.org/topic.cfm?topic=A00297 http://www.aaos.org/news/aaosnow/sep10/clinical10.asp http://www.youtube.com/watch?v=kB98kPLOcBM http://www.youtube.com/watch?feature=player_detailpage&v=q96M0jRqn7k http://www.youtube.com/watch?v=WvlJ-1XHudA

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