Specialists

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Partial Thickness Rotator Cuff Tears: Treatment

Partial thickness rotator cuff tears can result from intrinsic cuff degeneration and tendinopathy absent an injury or impingement. The lack of uniformity of collagen bundles and the paucity of vascular supply contributes to weakness, especially along the articular aspect of the rotator cuff. These degenerative tears often exit the articular surface and can be well […]

Open Nonanatomic Repairs

Latarjet was the first to describe the technique of using a portion of the coracoid transferred to the anterior glenoid as a buttress to anterior humeral translation in 1958. In this procedure, the transfer includes a portion of the coracoacromial ligament that is sutured to the capsular tissue through a short horizontal incision made in […]

Principles of Instability Surgery

The goal of treatment in both open and arthroscopic instability surgery is twofold: to restore the labrum to its anatomic attachment site and to re-establish the appropriate tension to the inferior capsuloligamentous complex of the joint. Cadaveric studies have shown that both the labrum and the capsule must be injured for a dislocation to occur.

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Valgus movement

Positioning.

The heel rests on the couch, the knee is slightly flexed and the ankle in neutral position. The examiner is distal to the foot and grasps the heel between the clasped hands. In order to avoid movements in the ankle joint the talus is stabilized between tibial and fibular malleoli. This is achieved […]

PASSIVE TESTS OF THE SUBTALAR JOINT

Varus movement

Positioning.

The heel rests on the couch with the knee slightly flexed and the ankle in neutral position. The examiner is distal to the foot and grasps the heel between the clasped hands. In order to avoid movements in the ankle joint the talus is stabilized between tibial and fibular malleoli. This is […]

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 […]

Posterior drawer test

Positioning.

The subject lies in the supine position with the knee flexed to a right angle, and the heel resting on the couch. The examiner sits on the foot of the subject. The heel of one hand is placed on the tibial tuberosity and the other hand is placed at the back of the upper […]

Passive medial 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 medial rotation. The range of movement is assessed by the twisted position of the feet.This test compares the range of internal rotation.

Common pathological situations:

• Lateral pain usually indicates a […]

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:

• […]

FUNCTIONAL EXAMINATION OF THE KNEE

Introduction/general remarks

The knee is the largest and most complex joint of the human body. Because it is situated at the ends of two long lever arms it is very well suited to clinical testing. Furthermore, the joint is relatively uncovered by muscles which facilitates palpation of most structures, intra-articular structures excluded.

One should warn […]