Knee disorders
Maneesh Bhatia, Tim Jennings in An Orthopaedics Guide for Today's GP, 2017
The knee joints are covered only by a thin layer of soft tissue and bear the weight of the whole body above them. Although it is a hinge joint with primarily flexion–extension movement, it also allows rotatory movements. The joint stability is provided mainly by soft tissues rather than significant bony structures. The primary stabilisers are the ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL) and posterolateral corner (PLC), providing support in translations, angulations and rotations. The crescent- and wedge-shaped medial and lateral menisci increase the depth and contact surface area for the femoral condyles and allow rotatory movement on top of the tibia plateau. A congruent and healthy cartilage allows painless and functional range of movements. The joint capsule provides the remaining stability. An injury to any of these structures may disturb the homeostasis of the knee.2
Treatment of Myofascial Pain Syndromes
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Trigger points may also be directly related to underlying articular dysfunction (Ellis & Johnson, 1996). In the treatment of myofascial pain, the practitioner must evaluate and, when indicated, treat both soft tissue and joint dysfunction. Muscular and joint dysfunction are closely related and should be considered as a single functional unit (Janda, 1994). Restrictions in joint capsules inhibit muscle function for those muscles overlying the particular joint. Conversely, muscle dysfunction results in joint capsule restrictions (Dvor;ák & Dvor;ák, 1990; Warmerdam, 1992). Zygopophyseal joints may have referred pain patterns similar to MTrPs (Bogduk & Simons, 1993; Dwyer, Aprill, & Bogduk, 1990; McCall, Park, & O’Brien, 1979). In addition, Butler (2000) suggests that impaired mechanics and physiology of the nervous system may be another contributing factor in the overall etiology of various pain problems, including myofascial pain. Somatic dysfunction affecting muscle and joint may result in restricted range of motion and weakness that can be rather quickly reversed by manual therapy.
Congenital Vertical Talus
Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel in Essential Paediatric Orthopaedic Decision Making, 2022
Softtissue contractures Joint capsules and ligaments Ankle joint—posterior capsuleTalo-navicular joint—dorsal capsuleTendons Achilles tendonTibialis anteriorExtensor digitorum & extensor hallucisPeroneus longus and brevis
Isolating the Superficial Peroneal Nerve Motor Branch to the Peroneus Longus Muscle with Concentric Stimulation during Diagnostic Motor Nerve Biopsy
Published in The Neurodiagnostic Journal, 2022
Ashley Rosenberg, Rachel Pruitt, Sami Saba, Justin W. Silverstein, Randy S. D’Amico
Arising from the sciatic nerve, the CPN travels in the posterior thigh to cross the lateral head of the gastrocnemius muscle to enter the anterolateral portion of the leg just below the fibular head. Here, the CPN divides into articular, deep, and superficial divisions (Figure 3A). The articular division innervates the joint capsule. The DPN innervates the anterior leg muscles responsible for dorsiflexion and terminates in a cutaneous branch between the first and second toe. The SPN provides motor innervation to the peroneus longus and the peroneus brevis only. Otherwise, the SPN provides cutaneous innervation to the lateral leg below the knee (D’Amico and Winfree 2017). The peroneus longus and peroneus brevis are located in the lateral portion of the leg and function primarily to evert the ankle, with the peroneus brevis considered more effective as an evertor than the peroneus longus (Lee et al. 2011). Both muscles also function in conjunction with the tibialis posterior in plantar flexion of the foot at the ankle (D’Amico and Winfree 2017).
Reliability of pressure pain, vibration detection, and tactile detection threshold measurements in lower extremities in subjects with knee osteoarthritis and healthy controls
Published in Scandinavian Journal of Rheumatology, 2018
P Jakorinne, M Haanpää, J Arokoski
There were no significant differences in TDT values between the three test sites. PPTs were lowest on the medial tibial condyle in both groups. Periosteum has been shown to be more sensitive for hypertonic saline-evoked pain compared to other deep structures such as muscle (41). As the excitation of nociceptors is potentially affected by various tissue layers that influence the distribution of mechanical stimuli (41, 42), it may be hypothesized that the thickness of subcutaneous adipose tissue, which is low in this area, may also affect the sensitivity to pressure-evoked pain (41, 43). Furthermore, it can be hypothesized that the higher compliance of the joint capsule also influences the distribution of the mechanical stimulus and thus may explain the differences between these tissue components. Although not previously investigated in subjects with knee OA, Marques et al (44) showed in fibromyalgia subjects and controls that the most sensitive areas for pressure pain were at the proximity to bone surfaces, such as lateral epicondyles, and the most sensitive point in the patient group matched the one in the control group, as shown in our study. However, opposite findings from healthy subjects were reported by Rolke et al (45), with higher PPTs on bony prominences than over muscles of the foot, and some studies have shown no differences between bone and muscle in healthy volunteers (46, 47).
Sub-millimetre accurate human hand kinematics: from surface to skeleton
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Jumana Ma’touq, Tingli Hu, Sami Haddadin
Thumb model DoFs and accuracy. The difference between the estimated and measured 7. From there, it becomes clear that the insufficient number of DoFs affects the accuracy of the model. In the 4 DoF model an error is observed in all 2004; Cerveri et al. 2007; Metcalf et al. 2008; Parasuraman and Zhen 2009; Cobos et al. 2010; Cordella et al. 2014), considering the Ab/Ad is of vital importance to reconstruct tip positions accurately. In our pilot experiment, a combination of F/E and Ab/Ad at IP joint was observed, especiallyduring physical interactions between the thumb segments and the grasped object, where the DP of thumb rolls over the object’s surface to achieve a stable grasp. This phenomenon might be related to elastic joint capsules. Besides, there are non-constant bone segment lengths being reconstructed by 4 DoF and 5 DoF models. To tackle these issues, a 6 DoF model is proposed which includes 5 active DoFs and 1 passive DoF. The proposed thumb model has an improved accuracy in all 7. Compared to the literature models (Table 2) our proposed 6 DoF model has proved to provide significantly better accuracy with no difference was noticed between measured and estimated
Related Knowledge Centers
- Anatomy
- Bone
- Dense Connective Tissue
- Synovial Joint
- Synovial Membrane
- Shoulder
- Adhesive Capsulitis of The Shoulder
- Plica Syndrome
- Capsule of The Glenohumeral Joint
- Articular Capsule of The Knee Joint