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Total Knee Replacement

Your Total Knee Surgery

There are several ways to treat the pain caused by arthritis. One way is total knee replacement surgery. The decision to have total knee replacement surgery should be made very carefully after consulting your doctor and learning as much as you can about the knee joint, arthritis, and the surgery.

In […]

Knee Fractures in Singapore

The knee is the joint between the femur (thigh bone) and the tibial (lower leg). In front of the knee joint is the patella (kneecap), a bone set in the tendon of the big quadriceps muscle which straightens the leg. Knee fractures are injuries to one or more of these bones close to the knee […]

Structure And Architecture Of Skeletal Muscle

Histology

Understanding the structure and architecture of skeletal muscle begins at the level of the muscle cell, or fiber, itself. Muscle fibers are multinucleated cells with a cylindrical shape, and they have diameters ranging between 10 to 100 µm. Fibers range a few millimeters to several centimeters in length. This wide variation in muscle fiber […]

Small Proteoglycans of Articular Cartilage

Small proteoglycan molecules consisting of biglycan, decorin, and fibromodulin represent approximately 5% of the proteoglycan of articular cartilage. Dermatan sulfate proteoglycans were first observed in articular cartilage by Rosenberg in 1985. The small proteoglycans each consist of a protein core and glycosaminoglycan chain branches.

The core protein of the small proteoglycans is only one fourth […]

Synovial thickening

Synovial thickening is a vital c1inkal finding. It indicates primary inflammation of the synovia and differentiates this from a secondary synovitis.Synovial swelling is best detected at the medial and lateral condyles of the femur, about 2 cm posterior to the medial and lateral edges of the patella.

Here the capsule lies almost superficially,covered only by […]

Provocation tests for meniscal tears

Significance

These tests are used to detect, by demonstration of clicks and / or pain, meniscal tears in the absence of actual (sub)luxations. If clicks are detected, it is wise to examine the other limb as well in order to eliminate non-pathological clicks arising from tendons snapping over bony prominences.

Test I

Positioning.

The subject […]

SPECIFIC TESTS-Medial shearing

Significance

This test is used to detect internal derangement at the inner side of the knee. Pain on jerk is suggestive for a minor lesion at the tibial insertion of the anterior cruciate ligament.

Positioning.

The subject lies in the supine position with the knee flexed to a right angle, and the heel resting […]

Anterior drawer test in external rotation

Positioning.

The subject is positioned as for the previous test. The lower leg and foot are externally rotated as far as is comfortably possible.The examiner places both hands around the upper part of the tibia with the index fingers on the hamstring tendons and the thumbs at the anterior border of the joint .

Procedure. […]

Passive lateral rotation in prone position

The subject lies in the prone position with both knees flexed to a right angle. The examiner encircles both heels and performs a bilateral external rotation. The range of movement is assessed by the twisted position of the feet. This test may be decisive in comparing the range of external rotation.

Common pathological situations:

• […]

Palpation of the popliteal fossa

The borders of the lozenge-shaped popliteal fossa are formed by the gastrocnemii, the biceps femoris and the semitendinosus and semimembranosus muscles. The bottom is formed by the posterior capsule and the popliteus muscle .The popliteal fossa is covered by a fascia. The lozenge is vertically crossed (from lateral to medial) by: the tibial nerve, popliteal […]