Anatomy

 One synovial cavity and

two joints (tibiofemoral
and patellofemoral
joints)
 Ligaments:
 Medial collateral

ligament
 Lateral collateral

ligament
 Anterior cruciate

ligament
 Posterior cruciate

ligament
 CLINICAL ASSESSMENT
 INSPECTION
Skin
Deformity
Swelling
 PALPATION
Confirm inspection
Tenderness,
hotness,…
 MOVEMENTS
Active
Passive
Abnormal
 SPECIAL TESTS
Test for Stability
Test for Effusion
KNEE EFFUSION… HAEMARTHROSIS
BACK OF THE KNEE
 Deformities
 Normally, about 7 degrees valgus between
anatomical axis of femur and tibia in
adults.
 Genu varum:
Physiologically in children up to 4
years old excluding pathological causes
e.g. rickets.
Always pathological in adults.
 Genu valgum:
Physiologically in children 4-8 years
old.
DEFORMIT VARUS
Y

FLEXION VALGUS
TRAUMA
FRACTURE
S

TRAUMATIC INJURIES-FEMUR
 Fracture tibial
plateau
 Types:
1. Split type
2. Split depression type
3. Depression type
4. Medial condyle
5. Bicondylar type
6. Plateau fracture extending
into metaphysis and
diaphysis
– Treatment:
 Undisplaced: Cast
immobilization
TRAUMATIC INJURIES
 Supracondylar
fracture femur:
Distal fragment tilted
posteriorly by the pull of
gastrocnemius muscle.
Risk of injury to
popliteal vessels and
tibial nerve
 Treatment:
ORIF by plate and
screws, or supracondylar
nail
 Fracture patella
 Types
1. Transverse
displaced or
undisplaced
2.Comminuted
 Fracture patella
 Treatment:
• Undisplaced:
back splint or
plaster cast.
• Displaced:
ORIF (tension
band).
• Comminuted:
Partial or total
patellectomy
KNEE DISLOCATION
 Internal derangement of the
knee
Ligamentous
injuries
 Types
– Mild: microscopic
rupture of ligament
fiber
– Moderate:
macroscopic rupture
of few ligament fibers
– Severe: macroscopic
rupture of most
ligament fibers
In type 1 & 2 –> Stable
joint
 Diagnosis
 History: mechanism of
injury, giving way
 Clinical examination,
special tests
 Imaging, MRI
 Arthroscopy
 Treatment
 Mild and moderate:
Splinting
 Severe
repair of collateral lig
reconstruction for
cruciate lig
 Meniscal injuries
 Medial meniscus
attached to deep part
of medial collateral
ligament  less mobile
 more liable for injury
(20 times) than lateral
meniscus.
 Types:
 Longitudinal:
undisplaced &
displaced (bucket
handle)
 Horizontal
 Radial

 Diagnosis:
 History: mechanism of injury, locking
 Clinical examination, special tests
 Imaging
 Arthroscopy
 Treatment:
1. Excision: partial, subtotal, total
meniscectomy.
2. Repair.
CALCIFIED MENISCUS
 SPECIAL
RADIOGRAPHY

RADIO ACTIVE ISOTOPE SCAN

MONOPEDAL STANDING

MRI SKYLINE VIEW

C T SCAN
ARTHROSCOPY
DEGENERATIVE
ARTHROSIS
((O A
TIBIAL OSTEOTOMY VS KNEE 

ARTHROPLASTY
LOOSE BODIES
INFECTION
TUMOURS
TUMOURS
TUMOURS
TUMOURS
BURSAE