Pta 216 Ortho Knee Foot And Ankle

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a

Back 1

a

Front 2

b

Back 2

b

Front 3

c

Back 3

c

Front 4

petello femeral syndrome

Back 4

Deviations of patellar tracking throughout knee flexion and extension causing pain and inflammation

Patient may report pain with: . Ascending/descending stairs . Squatting . Kneeling . Transferring hom sit to stand -Most common in women secondary to an increased Q-angle p3

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Patello-Femoral Syndrome Rehabilitation includes:

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. Stretching the hamstrings . Modalities as needed . Strengthening the quadriceps . (specifically the VMO) . Strengthening the hip Abductors and hip flexors . Bracing and/or taping as needed

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Chondromalacia ofthe Patella .

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Softening of the cartilage of the knee, usually following injury . Characterized by edema, pain, and degenerative changes ●Rehabilation includes: decreasing pain and inflammation, increasing strength & flexibility

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patellar tendonitis

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An overuse injury resulting in inflammatory changes. . Characteristics:

. Pain on palpation

. Sharp pain initially with deceleration activity

. Afterward, a dull ache is typically reported

. Conservative Treatment: . Activity modification . Eccentric exercises . Muscle Balancing . All pain free!!

(jumpers knee)

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muscle strains

Back 8

grade 1 involves tearing of a few fibers mild pian and minimal loss of strength

2 partial tearing of muscle some loss of strength pain is elecituded with

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muscle strains

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p5 s2

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muscle strains

grade.1.2. treated

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p5

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myscle strain 3 treated with

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p5 s3

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dislocation of the patella

Back 12

Occurs when the patella fully dislocates from within the trochlear groove of the femur. resting outside ofthe knee joint First dislocation is a pre-disposition to further dislocations secondary to the tearing of the medial patello-femoral ligament (MPFL) Treatment . Strengthening, stabilizing, and bracing

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dislocation of the patella

surgical intervention

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Lateral Release: the tight lateral structures are cut to allow better anatomic positioning of the patella in the trochlear groove

. Cautious movement in knee flexion is initiated early to prevent scarring down of the released structures

p6

Front 14

Osteochondritis Dissecans

Back 14

Joint disease in which a piece ofcartilage and neighboring bone tissue become detached from the articular surface

+ Symptoms: . Pain . Clicking in the joint . Tenderness . Edema . Stiffness

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Osteochondritis Dissecans

treatment

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Conservative treatment is usually successful: . Rest . Immobilization . Anti-innammatory medication . Modified activity (approx. 6-8 weeks) ' Physical Therapy: stretching, ROM, strengthening exercises and low impact cardiovascular activity 'Surgical intewention would include stabilization and/or removal of fragments

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fracture if the tibial plataue

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ligamentous injury

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p8 slide

1

3

3

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grading of ligamentous injury

grade 1

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g1

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grading of ligamentous injurygrade 2

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gr2

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grading of ligamentous injurygrade 3

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g3

p9

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Ligament Reconstruction

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: ' 2 types ofgrafts used for reconstruction purposes ' Autograh: tissue harvested from the body ofthe patient . Hamstring Achilles, patellar, quadriceps ' Allograft: tissue harvested from the body ofa donor (usually hom a cadaver)

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Ligament Reconstruction allograpft risk

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disease transmition

.001%

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Meniscal Injuries

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Meniscus: cartilagenous tissue which serves,as an extension of the tibia providing support of the femora] condyles on the surface of the tibia Functions of the meniscus: 'Stability *ShockAbsorption *l.oad transmission 'Control of motion *Nutrition 'Lubrication

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meniscal injuries

Mechanism of injury:

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: flexion, rotation, . Trauma (usually a combination of knee f ] compassion, and shear) . Gradual degeneration: subtly with no specific injury

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meniscal Injuries: p11

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' Injuries are marked by edema, catching and/or locking within the joint ' Management of these injuries is based upon the severity and location of the tear ' Surgical Treatment: . removal ofthe damaged portion ofthe meniscus . Non-surgical Interventions: decrease pain and inflammation, increase strength and increase joint stability '

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Knee Arthroplasty

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Removal of the articular surface of the tibia and femur (occasiona//y fnc/fides rhe pate//a) and replacing them with metal or plastic . Primary indications for total knee arthroplasty (TKA) include: . Osteo-arthritis (OA) /Degenerative Joint Disease (DJD)