Assessing the knee joint

By: Emiliano, Brayden, Ryan, Riley

History
History
 The human knee connects the thigh to the leg and is made up of two joints:
the patellofemoral joint, which is located between the patella and the femur,
and the tibiofemoral joint, that’s between the femur and the tibia.
 The human body's largest joint is this one. The knee is a hinge-joint that
allows for some internal and external rotation in addition to flexion and
extension.
 The knee joint is vulnerable to damage and the development of arthritis and
other things.
 It’s also referred to as a compound joint.
Observation/Leg alignment
Observation

 Observation of the knee joint is part of a physical

examination to assess the condition and function of the
knee and surrounding structures. It involves inspecting,
palpating and moving the knees, and comparing both
sides. It can help identify signs of injury, inflammation,
deformity or instability
When performing a knee observation, you should
 Examine and compare both knees and surrounding
structures.
 Inspect for wounds, erythema, rashes, deformity, muscle
atrophy and swelling.
 Palpate for warmth, swelling (including bony swelling,
effusion and bursal or other soft tissue swelling) and
tenderness.
 Move the knees by extending and flexing as far as
possible.
 Leg Alignment
Knee joints not aligning can be caused by several
conditions
 True locked knee: Torn knee cartilage becomes
wedged in the joint, making it impossible to bend
or straighten the knee
 Pseudo-locked knee: Severe knee pain triggers a
defensive reaction that impedes knee movement
 Patellar tracking disorder: Movement of the
kneecap that isn’t aligned, like your kneecap
moving sideways
 Osteoarthritis of the knee: Cartilage in your knee
joint breaks down, causing the bones in your
knee joint to rub together, making your knees
hurt, become stiff or swell
 Bowlegs (varus deformity) or knock knees (valgus
deformity): When our legs are not aligned
straight at the hips, knees, and ankles, there can
be an abnormal force across the knee, causing
pain in the hip, knee, and ankle
Special Tests
Lachman’s Test

 Lachman's Test
 The Lachman test is a specific
clinical exam technique used to
evaluate patients with a
suspected anterior cruciate
ligament ACL injury.
 The test is considered positive if
there is excessive anterior
translation of the proximal tibia
greater than the uninjured side
and also a lack of a firm
endpoint.
Anterior Drawer Test

 The anterior drawer test is a

knee assessment that your
doctor, physical therapist, or
sports therapist uses to check for
an ACL injury.
 The test is considered positive if
there is a lack of end feel or
excessive anterior translation
relative to the contralateral
side.
 Or if the tibia pulls forward or
backward more than normal.
Pivot-Shift

 The pivot shift is a

useful physical exam
maneuver for diagnosis
of rotatory instability
related to ACL tear.
 A positive test is seen
with a rapid anterior
subluxation of the tibia
at 20–30° of flexion as
it reduces under the
femoral condyles.
Palpitation
Palpitation

 One of the key points of a physical

exam is to determine the exact
location of a patient’s pain, so one
can correlate it to the history and
specific anatomic parts.
 This helps to localize the area of
the pain.
 In general, you want to palpate the
area that hurts the most last so that
other areas of injury may be
accurately assessed to prevent a
patient guarding due to pain
occurring during the physical exam.
Methods of palpitation

Method 1: Palpate the extensor mechanism: Start with quadriceps muscle and
quadriceps tendon, feel around the patella and the patella ligament, and then press
over the tibial tuberosity.

Method 2: Assess for fluid by placing one hand superior to the patella and with slight
downward pressure milk the suprapatellar pouch which emptys into the knee joint.
Next use the other hand to push to push on the patella. If there is an effusion, the
patellar will bounce off the underlying bone (patella tap test).
Structures

Structures for Palpation

 MCL.
 LCL.
 Joint Line.
 Patella.
 Retinaculae.
 Patellar Tendon.
 Hamstrings Tendons.
 Popliteus.
Thank You!