(for Discogenic Pain) – Discussion: – performed with the patient prone with arms at the sides; – examiners thumbs finds an interspace and exerts sharp downward pressure seeking a reproduction of pain; – several interspaces are tested to find levels that are not painful for comparison; – if no … Read more
– Discussion: – one of most common knee injuries in children; – most common in children between ages of 8-14 yrs; – usually result from avulsions of anterior intercondylar eminence from pull of ACL; – fragment of tibial spine may be non displaced, or … Read more
– See: – Anteromedial Instability – Anterolateral Instability – external rotation – Discussion: – internal-rotation laxity increases w/ knee flexion, w/ largest amount (25 degrees) seen in the 20 to 40-degree range of knee flexion; – of all of structures around the knee, only MCL and ACL play an important role in the … Read more
– Discussion: – in normal knees, constant relationship exists between length of patella (LP) and length of the patella tendon (LT); – length of tendon (LT) is measured on its post surface from the lower pole of patella to its insertion on top of tibial tubercle; … Read more
– Destot’s sign: – superficial hematoma above inguinal ligament or in scrotum or thigh; – may indicate a pelvic fracture, as may a limb-length discrepancy or obvious rotational deformity of the pelvis or lower extremity; – Roux’s sign: – a decrease in the distance from the greater trochanter to … Read more
– Discussion: – innervated by branches of obturator, femoral, & sciatic nerves; – Anterior and Posterior Innervation Groups: – posterior group: – posterior articular nerve of tibial nerve which crosses posterior capsule at level of oblique popliteal ligament; … Read more
– Discussion: – methods to prevent infection – report by by Peersman G, et al . – comorbidities that were statistically significant in increasing the risk of infection were prior open surgical procedures, immunosuppressive therapy, poor nutrition, hypokalemia, diabetes mellitus, obesity, and a history of smoking. – prevalence of infection after … Read more
– See: Total Hip Replacement Menu: and see total knee replacement infections – Diagnosis: – diagnosis of septic loosening is initially based on history, x-ray findings, and elevated sed rate; – clincially patients may note increasing pain at both rest and with activity; – despite the variety of tests available, it may be difficult to distinguish … Read more
– See: TKR menu, work up of the painful knee, and prevention of infection and infected THR; – Diagnosis: – early dx of an infected prosthesis requires a high index of suspicion. – infection may cause only knee pain, persistent effusion, or early painless loosening, or more obvious signs, including inflammation, drainage, and sepsis; – classification: (ref: … Read more
– See: Patella in TKR Menu – TKR w/o resurfacing: – less than 20 mm of patella thickness is a relative contraindication for patellar resurfacing; – if unsure as to whether or not resurfacing will be performed, then use a TKR design which specifically will accomodate unresurfaced patella; – in report by Barrack, et al, authors … Read more