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Knee
Sam and Matt
Disease: Osteoarthritis
Knee with Osteoarthritis
Osteoarthritis
o Symptoms
▪ Swelling
▪ pain that increase with activities
▪ warmth in the joint
▪ stiffness in the knee
▪ decrease in mobility of the knee
▪ creaking, crackly sound
o treatment
▪ weight loss
▪ exercise
▪ pain relievers and anti-inflammatory drugs
▪ corticosteroids or hyaluronic acid
▪ braces
▪ physical and occupational therapy
▪ surgery
Treatment: Arthroscopy
https://www.youtube.com/watch?v=nAj2_pgTkEA
Baker’s Cyst
● Symptoms
o no pain
o tightness or stiffness behind the knee
o swelling behind the knee that may get worse when you stand
o slight pain behind the knee and into the upper calf.
● Diagnosis
o comparing two knees
o MRI
o transillumination
o x-ray doesn’t show the cyst
Treatment for Baker’s Cyst
Arthroscopy
https://www.youtube.com/watch?v=UmavjR6sg_I
Osgood Schlatter Disease
o inflammation where patellar tendon attaches to the tibia
o Cause:
● Overuse of knee area before it is finished growing
- common cause of knee pain in growing adolescents
● growth spurts when the structures are changing rapidly.
● hyperactive (eg: athletic children)
Osgood Schlatter Disease
o symptoms
▪ knee pain and tenderness at the tibial tubercle
▪ swelling at the tibial tubercle
▪ tight muscles in the front or back of the thigh
o treatment
▪ Stretching exercises
▪ non-steroidal anti-inflammatory medication
o Surgical Treatment is rarely indicated in children
Osgood Schlatter Disease
o physical therapy
▪ acute phase
● infrapatellar strap may be recommended but has no proven efficacy
● resting recommended when pain arises
● 20 minutes of icing after activities
▪ recovery phase
● exercises: wall slides, squat below 90 degree, straight leg raises, short-arc quadriceps
Meniscus Tear
Bucket Handle Tear Flap Tear
Radial Tear Degenerative Tear
Meniscus Tear
Meniscus Tearo Symptoms
▪ You may feel a pop when tearing meniscus
▪ over 2~3 days the knee will be more stiff and swollen
▪ Pain
▪ Stiffness and swelling
▪ Catching or locking of knee
▪ knee feels like giving away
▪ not able to move your knee in full range of motion
o Examination
▪ X ray- does not show meniscus tear
▪ MRI- better images of the soft tissues of knee joint (meniscus)
Meniscus Tear
Meniscus Tear● Treatment
o Non surgical
▪ Rest
▪ Ice
▪ Compression
▪ Elevation- leg high up higher than your heart
▪ non-steroidal anti-inflammatory medicines
o surgical
▪ arthroscopic
● partial meniscectomy→ damaged meniscus tissue trimmed away
Partial Menisectomy
Meniscus Tear
● Meniscus repair →
● Total meniscectomy→
Total Knee Replacement: Causes
Osteoarthritis
Rheumatoid Arthritis
Post traumatic Arthritis
Bowed leg
Total Knee Replacement: Diagnosis
http://orthoinfo.aaos.org/topic.cfm?topic=a00389
Total knee replacement: Procedure
http://orthoinfo.aaos.org/topic.cfm?topic=a00389
https://www.youtube.com/watch?v=kAMuP2MNqUo
Total Knee Replacement
http://orthoinfo.aaos.org/topic.cfm?topic=a00389
Total Knee Replacement: Post-Op
http://orthoinfo.aaos.org/topic.cfm?topic=a00389
http://www.mayoclinic.org/tests-procedures/knee-replacement/basics/risks/prc-20019202
Partial Knee Replacement (Unicompartmental)
http://orthoinfo.aaos.org/topic.cfm?topic=A00585
https://my.clevelandclinic.org/services/orthopaedics-rheumatology/treatments-procedures/hic-partial-knee-replacement
Partial or Total Knee Replacement?
http://orthoinfo.aaos.org/topic.cfm?topic=A00585
https://www.dmc.org/cartilagedefects
Partial Knee Replacement: Post-Op
http://orthoinfo.aaos.org/topic.cfm?topic=A00585
OATS
Osteoarticular Transfer System
For Cartilage repair/transfer.
https://www.youtube.com/watch?v=jRH0Q26TWms
PCL Tear
https://www.youtube.com/watch?v=gqHDtiU7y2M
ACL tear
http://orthoinfo.aaos.org/topic.cfm?topic=a00549
ACL tear cont.
http://physioworks.com.au/injuries-conditions-1/acl-anterior-cruciate-ligament-injuries
ACL tear: Symptoms and Diagnoses
http://orthoinfo.aaos.org/topic.cfm?topic=a00549
PCL & ACL: Treatment Options Nonsurgical:
● RICE● Immobilization● Physical Therapy
Surgery: ● ACL reconstruction
PCL & ACL: Surgical Procedure
http://www5.aaos.org/icm/default.cfm?screen=icm004_s07_p4
Review
Review cont.
Review cont.
This is a horizontal x-sectional view
MRI image
Review cont. MRI
http://radsource.us/wp-content/uploads/2008/02/4a.jpg
Reference
o http://www.mccc.edu/~behrensb/documents/StrucKneebjb.pdf
o http://www.webmd.com/osteoarthritis/guide/ostearthritis-of-the-knee-degenerative-arthritis-of-the-knee?page=2
o https://www.youtube.com/watch?v=OXGx4jK_q3k
o http://www.webmd.com/pain-management/tc/bakers-cyst-topic-overview
o http://orthoinfo.aaos.org/topic.cfm?topic=a00549
o http://orthoinfo.aaos.org/topic.cfm?topic=a00420
o https://www.nlm.nih.gov/medlineplus/ency/article/002972.htm
o http://orthoinfo.aaos.org/topic.cfm?topic=a00109
o http://orthoinfo.aaos.org/topic.cfm?topic=A00585
o https://my.clevelandclinic.org/services/orthopaedics-rheumatology/treatments-procedures/hic-partial-knee-replacement
o http://orthoinfo.aaos.org/topic.cfm?topic=a00389
o http://www.webmd.com/pain-management/video/knee-replacement
o https://www.youtube.com/watch?v=kAMuP2MNqUo
o http://www.mayoclinic.org/tests-procedures/knee-replacement/basics/risks/prc-20019202
o http://www.sportsmedicineofnapavalley.com/uncategorized/what-is-osteoarticular-transfer-system-oats-surgery/
o http://knee1.com/Education_Center/Therapies/OsteoArticular_Transfer_System
o http://www.webmd.com/pain-management/knee-pain/meniscus-tears
o http://orthoinfo.aaos.org/topic.cfm?topic=a00358
o http://orthoinfo.aaos.org/topic.cfm?topic=a00411
o http://emedicine.medscape.com/article/1993268-treatment#d11
o http://www.webmd.com/pain-management/tc/bakers-cyst-topic-overview
