Janice’s painful knee

Janice’s painful knee

1. Anatomy of knee joint

   • Tibiofemoral
     • Between the tibia and femur
     • Synovial hinge
   • Patellofemoral
     • Between the patella and femur
     • Synovial plane
   • Menisci
     • Fibrocartilage present on the superior surface of tibia
     • Medial
       • Oval shaped
     • Lateral
       • Rounded
     • 3 functions
       • Joint stability
       • Deepens the articular surface
       • Shock absorption
   • Ligaments
     • Intra-capsular
       • ACL
         • Prevents hyperextension of the knee
       • PCL
         • Prevents forward displacement of femoral condyles ( during flexion )
       • Posterior meniscofemoral
       • transverse ligament of the knee
     • Extra-capsular
       • MCL
         • On the medial side limits abduction
         • Injury causes Genu valgum
       • LCL
         • On the lateral side limits adduction
         • Injury causes Genu varum
       • Oblique popliteal ligament
   • Joint capsule
     • Present on all sides except anteriorly
       • Replaced anteriorly by
         • Quadriceps tendon
         • Patella
         • Patellar ligament

2. Causes of knee pain

   • Pain is mostly related to aging, injury or repeated strain on the knee
     • Knee sprains
       • Torn or overstretched ligament
     • Osteoarthritis
     • Meniscal tears
       • Caused by trauma to the knee
     • Patellar bursitis
       • Friction between the skin and the patella
         • Inflammation
     • Tendonitis
       • Inflammation of the tendons may result from overuse of a tendon

3. Pathophysiology of OA

   • OA is a chronic musculoskeletal disease that frequently affects the large weight-bearing Joints
   • degenerative disease that affects the cartilage
     • Pathologic features
       • Disruption of the cartilage that lines the articular surface
       • Eburnation of the subchondral bone
       • Cyst formation in subchondral bone
       • Osteophyte formation

4. Risk factors and symptoms of OA

   • Risk factors
     • Age
     • Gender
       • Females are more commonly affected
     • Obesity
     • Hereditary
   • Symptoms
     • Develop slowly overtime
     • Pain
     • Stiffness
     • Loss of flexibility
     • Swelling

5. Management of OA

   • Pharmacological
     • Mainly targeting the pain and inflammation
       • Paracetamol
         • Targets pain
       • NSAIDs
         • Decreases pain + inflammation by inhibiting COX enzyme
   • Non-pharmacological
     • Weight loss
     • Physiotherapy
       • Combination of
         • Strengthening exercises
         • Flexibility exercises
     • Hydrotherapy
       • Reduces the pressure on joints + builds strength
     • TENS
       • Pain relief

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