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Painful knee

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Painful knee

Causes
- Due to
  - Injuries
  - Mechanical Problems
  - Types of arthritis
Knee joint region
- Type of joint
  - Tibio-femoral joint = Hinge
  - Patello-femoral joint- Plane
- Articular surfaces
  - Articula surfaces of femoral condyles
  - Upper surfaces of the tibial condyles
  - Back of the patella
  - Fibula is not included in the knee joint
  - Cartilage
    - What is it?
      - Semi rigid connective tissue, provides support
    - Components
    - Types
      - Histology
        Hyaline cartilage
        Elastic cartilage
        Fibrocartilage
- Joint capsule
  - Enclosed from all sides except anteriorly
    - Anteriorly it's replased by : 1. Quadriceps tendon \ 2.Patella \\ Patellar ligament & retinsculse
- Bursa in the knee region
Physical examination
- Stabiloty test
- Special tests
  - McMurray’s
  - Apleys Grinding Test
  - Patellar apprehension test (patellar sublaxtion)
Osteoarthritis
- What is it?
  - Most common joint disorder characterized by degeneration of the articular cartilage.
- Types
  - Primary - Aging
  - Secondary - Trauma
- Pathogenesis
- Stages
- Signs & Symptoms
  - Deep, aching pain exacerbated by use, and relieved by rest
  - Morning stiffness
  - Crepitus
  - Limited range of movement
  - Heberden nodes in the fingers
  - Bouchard's nodes
- Complications
  - Chondrolysis
  - Osteonecrosis
  - Stress fractures
  - Bleeding inside the joint
  - Infection in the joint
  - loss of stability
  - Pinched nerve
- Investigation
- Management
  - Patient education
  - Heat and cold
  - Weight loss
  - Exercise
  - Physical therapy
  - Occupational therapy
  - Knee replacement surgery is suggested if:
    - Severe knee pain that limits everyday activities
    - Moderate or severe knee pain while resting, day or night
    - Long-lasting knee inflammation
    - Knee stiffness
    - Bowing in or out of the leg
    - No pain relief from NSAIDs or can't tolerate them