MYAID Ortho-Glide Knee Exerciser/Slider for Rehabilitation After Surgery

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The fibular collateral ligament is a strong ligament that originates from the lateral epicondyle of the femur, just posterior to the proximal attachment of the popliteus, and extends distally to attach on the lateral surface of the fibular head.

Image: Overview of the knee joint (anterior and posterior views) [3] Anatomy [ edit | edit source ] Articulating Surfaces [ edit | edit source ] Trochlear geometry: The shape of the trochlea is concave. When the patella enters the trochlea, it allows for the inherent stability of the patellofemoral joint. When the patellofemoral joint is involved, it oftentimes creates a sero-sanginous synovitis response. Therefore, the first tests to be performed are effusion (intra-articular) vs edema, bursitis, hematoma, etc. (extra-articular) tests. There are several tests that can be performed, including milking tests, sweeping, and ballotment tests. Assessment of acute dislocation: Deformity and swelling that may mask a persistent lateral subluxation of the patella [2]Overuse injuries occur when training type, frequency, duration or intensity exceeds the body's ability to repair itself. These types of conditions are more common in athletes such as runners, or someone starting an overzealous exercise program. At times overuse of the anterior knee can also occur as a result of vocational activities, especially those that require repetitive squatting, stair climbing or walking. It must be remembered though that overuse injuries can present as an acute re-exacerbation of a condition; consequently an acute on chronic condition is not uncommon with PFPS. Branches of the popliteal artery: Lateral superior and inferior genicular arteries, the medial superior and inferior genicular arteries, and the middle genicular arteries. This product is simple and easy to use, I have to say is best on a wood or polished floor. Until I got the slider I could not comfortable place my foot flat to the floor on an upright sit. The slider allows you to push yourself at your own pace on a constant gentle push motion. Patellomeniscal ligament: comprised of a medial and lateral patellomeniscal ligament, often described as simply medial and lateral ligaments. These ligaments run from the inferior third of the patella to insert on the anterior portion of the medial and lateral meniscus, respectively. Minkowitz R., Inzerillo C, Sherman O. Patella Instability. Bulletin of the NYU Hospital for Joint Diseases 2007;65(4):280-293. (level of evidence 2b)

There is no consensus yet whether surgical or conservative treatment after patellar dislocation is preferable [12](level of evidence 1a) To assess this more research is needed. In any case, for both conservative and surgical treatment, physical therapy will be needed. The tibial plateaus are the two slightly concave superior surfaces of the condyles located at the proximal end of the tibia, and are separated by a bony protuberance known as the intercondylar eminence. The medial tibial articular surface is somewhat oval shaped along its anteroposterior length, while the lateral articular surface is more circular in shape Smith T, Bowyer D, Dixon J, Stephenson R, Chester R, Donell S. Can vastus medialis oblique be preferentially activated? A systematic review of electromyographic studies. Physiotherapy Theory and Practice. 2009;25(2):69-98. Deyle G., Allison S., Matekel R., Ryder M., Stang J., Gohdes D., Hutton J., Henderson N., Garber M. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther 2005 Dec;85(12):1301-1317.Chaurasia BD. Human Anatomy - Lower Limb, Abdomen and Pelvis. Vol 2. CBS Publishers and Distributors Pvt Ltd, 2010 The primary extensor of the knee joint is quadriceps femoris, assisted by the tensor fasciae latae. Quadriceps femoris of four muscle bellies; rectus femoris, vastus lateralis, vastus medialis and vastus intermedius, all innervated by the femoral nerve. Patella alta (engagement into the trochlea does not occur in the early phase of knee flexion, thus potentiating instability at the patellofemoral joint) [2] [6]

Intracapsular ligaments: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus, lateral meniscusAndrish J. The Management of Recurrent Patellar Dislocation. Orthopedic Clinics of North America. 2008;39(3):313-327.

After a first dislocation of the knee, a period of immobilization is appropriate. This is necessary to heal the soft tissues, especially the supporting structures on the medial side of the knee. There are several possibilities for immobilization: a cylinder cast, a posterior splint, a brace or a tape. There is no consensus yet on which type of immobilization is more appropriate. [21](Level of Evidence 2b) [22](level of evidence 1b) [23] (level of evidence 3a) Transverse ligament: connects the menisci anteriorly extending from the anterior margin of the lateral meniscus to the anterior horn of the medial meniscus. Its exact role is uncertain but it is thought that this ligaments stabilizes the menisci during knee movements and decrease tension generated in the longitudinal circumferential fibres. The lateral and medial condyles are two bony projections located at the distal end of the femur, which have a smooth convex surface, and are separated posteriorly by a deep groove known as the intercondylar fossa. The medial condyle is larger, more narrow and further projected than its lateral counterpart, which accounts for the angle between the femur and the tibia. The roughened outer surfaces of the medial and lateral condyles are defined as medial and lateral epicondyles, respectively. Along the posterior aspect of the distal femur, there are paired rough elevations above the medial and lateral epicondyles known as the medial and lateral supracondylar ridges. Medial rotation, as discussed earlier, occurs when the knee is in the last stage of extension, with some also occurring when the knee is flexed. It is primarily produced by the actions of popliteus, semimembranosus and semitendinosus, which are assisted by sartorius and gracilis. Lateral rotation is produced by biceps femoris and also occurs when the knee is flexed.Ligaments are bands of strong tissue that connect bone to bone. The knee has 4 major ligaments that connect the femur to the tibia: Both superficial and deep patellar retinacula need to be assessed in supine. Passive patellar glides are performed to assess the superficial lateral retinaculum and are performed with the knee in 30 degrees of flexion. 39, 40 Others report that testing should be done in full extension. 41, 42 Testing in full extension examines peripatellar soft tissue passive mobility solely. The authors preferred position is to test mobility in 30 degrees of knee flexion as the patella has started to enter the trochlea and provides a functionally stable position. In this position of slight flexion the clinician cannot only feel resistance from soft tissues, but also from the bony engagement of the patella into the trochlea. Most commonly patellar dislocations occur in this range, therefore it seems to be a functional position of testing. Non-operative treatment is usually attempted for 3 to 6 months. If that fails, surgical options are considered [9] [10] [11] Viewed in the sagittal plane, the femur's articulating surface is convex while the tibia's is concave. Knee arthrokinematics is based on the rules of concavity and convexity [11] and is described in terms of open and closed chains: Extracapsular ligaments: patellar ligament, medial and lateral patellar retinacula, tibial (medial) collateral ligament, fibular (lateral) collateral ligament, oblique popliteal ligament, arcuate popliteal ligament, anterolateral ligament (ALL)