It has been a few months since I have written a blog. The biggest reason was devoting my time to the River of No Return Race in Challis. We have been the medical providers for 5 years and I’m happy to report another successful year with no serious issues. Anyway, I’m now back on track and ready to resume a monthly blog.
As a PA, or I would assume any medical provider it is important to occasionally go back and review or rather re-review previous subjects. In Physiatry, we cover a lot of regions/body parts/joints, so for the next 2-3 months I’m devoting myself to study of the knee joint. On the surface, this sounds quite simple, but given the complexity of any joint, there are significant challenges. As evidenced by several Orthopedic Surgeons who concentrate/focus on 2 joints…like shoulder & knee or hip & knee, etc.
Anyway, my goal is to improve my skill in anatomy, diagnosing and treating conditions of the knee. My thought’s for this month’s blog were to just start with the basics, perhaps the least favorite, but likely the most important part, anatomy. If you are an expert in the knee, this will be rudimentary, but hopefully for the general populous it will have some helpful information. As with all my blogs, I would add the caveat that this is a basic/informational discussion. If you desire more education in the matter, there are numerous websites that can edify you further.
The basics---Once again notice the heading (the basics). First, let’s cover anatomy which is the foundation of medicine:
The knee is roughly comprised of 3 bones (Femur---thigh bone, Tibia---shin bone and Fibula---essentially non-weight bearing outside bone) and a portion of cartilage called the patella or knee cap. These structures compose 3 compartments of the joint (medial---inside, lateral---outside and patellar---under the knee cap).
There are 4 ligaments that comprise the knee joint (remember ligaments attach bone to bone). These are the Medial Collateral Ligament---MCL, the Lateral Collateral Ligament---LCL, the Anterior Cruciate Ligament---ACL (think football) and the Posterior Cruciate Ligament (PCL).
Adding in the muscle/tendon structures we have the Quadraceps and Hamstrings. Quick trivia question, who can name the 4 or 3 muscles associated with the quads or hams respectively. Answer: Quads = Vastus Medialis, Vastus Intermedius, Vastus Lateralis, Rectus Femoris. Hams = Semimembranosis, Semitendinosis, Biceps Femoris. Each of these muscles has a respective tendon…so tendon attaches muscle to bone.
Inbetween the joint or rather the femur and tibia there are menisci---an anterior/posterior portion for both the medial and lateral meniscus. Also, there is articulating cartilage---simply stated a slick surface that wraps the bottom of the thigh bone and top of the knee bone.
In keeping with the theme that this is the basics, this covers the knee joint and its basic components from an anatomical perspective. In the next blog, I will cover the typical problems or issues involved and how they relate to the knee and its function and possible pain generators.