Question

The following three questions relate to this scenario: Mr Smith, a 38 year old mechanic presents to your clinic with pain in the lateral knee region. He has recently returned to a highly active role at work after spending many years in an administration role.

List two treatment techniques that you could use to restore a malfunctioning “screw home mechanism.”

List three (3) features of the knee joint complex that promote stability and indicate, in relation to the types of examination skills , the specific techniques that you could use to assess these structures contributing to stability.

As part of your assessment, you discover that Mr Smith has pronated feet. Describe this postural deviation in terms of the joints of the foot.

Answer 1

knee joint helps in movement of flexion - extension..The radius and the length of the articular surface of the femur and tibia vary at the knee joint..sliding happens with some interval rolling between the two bones..length of the medial femoral condyle, the tibia rotates externally 15 degree on the femur during the last 20degree of extension..This is called screw-home movement or mechanism..
Two treatment methods:
Tibiafemoral Articulation:
Menisci - femoral condyles - the medial and lateral menisci provide additional compatability to the joint by their semicircular shape and peripheral thickness,it form wedge surrounding the femoral condyles..menisci varies during knee range of motion..In weight bearing, menisci total contact area decreases with knee flexion, but mean surface area increase in non- weight bearing conditions, total menisci contact area decrease during knee flexion..meniscectomy decrease the surface area make good stress upon the contact surface..
Axial forces:
Tibiafemoral joint ability imposed by super incembent weight of the body combined with ground reaction force transmitted by the distal extremity..femur longitudinal axis extends laterally to medially to the tibiofemoral articulation,make oblique angle 5 to 10 degree away from vertical..this alignment make good lateral femoral condyle load..it helps in weight bearing..
Three features:
Medial collateral ligament(MCL) or tibial collateral ligament..
Lateral collateral ligament (LCL) or fibular collateral ligament
Anterior cruciate ligament (ACL) center of the knee,limits rotation and femoral movement of the tibia..
Biomechanical technique and testing provides quantitative information on this ligaments to determine the effectiveness of certain treatment and surgical technique to assess changes in biomechanical parameters..
Pronated feet also known as supination..There is postural problems in adults..There will be rotation of the medial bones in the midtarsal region of the foot inward and downward..so while walking the foot come down on its inner margin..subtalar joint determine how the tibia and femur bones of the legs are lined up..over-pronated subtalar joint forces the tibia and femur bones to rotate inward,sometimes slightly, sometimes more severly..it will happen when we stand for long period and too much walking, too little activity, not running correctly, poor posture, genetics, dysfunction of tibialis etc..