Khup ruh inzawmna .

01. Ruh siam dan composition .

Chumi Knee joint ah hian ruh 4 a awm a, chungte chu femur, tibia, patella leh fibula te an ni.

Compartment 3 a awm a, chungte chu medial tibiofemoral compartment, lateral tibiofemoral compartment, leh patellofemoral compartment te, leh compartment 3 te hian synovial cavity an nei a ni.

02.Joint structure .

Type: Carriage Joint .

A khup hian joint 3 a nei a, chungte chu medial tibiofemoral joint, lateral tibiofemoral joint leh patellofemoral joint te an ni.

Tibiofemoral joint hian distal femur chu tibia nen a thlunzawm a, distal femur chu a taper a, medial femoral condyle leh lateral femoral condyle a siam a ni. Tibia hi a flat deuh a, mahse inclined meniscus chuan projecting femoral condyles nen inzawmna nghet tak a siam a ni.

Femoral condyles hi intercondylar fossa hmanga then a ni a, hei hi femoral groove emaw femoral talus emaw tia hriat a ni bawk.

Patella hi quadriceps muscle tendon chhunga seed bone embedded a ni a, trochanteric groove nen joint a siam a ni.

Quadriceps muscle-a mechanical gain tihpunna atan a thawk a ni. Fibula lu hi khup capsule chhungah a awm a, mahse weight-bearing articular surface angin a thawk tlangpui lo. Femoral condyles leh tibial plateau te hian joint line an siam a.

03. Joint stability .

Knee joint stability chu soft tissue hrang hrang hmangin a vawng reng a, chu chuan joint chhungah cushioning protection a pe bawk.

Tibia leh femur te chu khup ruh chhungah shock-absorbing hyaline cartilage hmangin an khuh a.

-Disc-shaped lateral leh medial menisci hian shock absorption dang a pe belh a, joint pumpuiah khup chungah force a sem bawk.

-The anterior cruciate ligament (ACL) leh posterior cruciate ligament (PCL) chuan anterior-posterior leh flexion-extension movement te chu a ti nghet a.

-Medial collateral ligament leh lateral collateral ligament te hian an plane-a khup chu an stabilize a.

-Khruk stabilize thei structure dang chu iliotibial bundle leh posterior lateral horn thenkhat a ni.

04. Bursae leh cystic structure te .

Cystic structure eng emaw zat chu khup chhehvelah hmuh tur a awm tlangpui a, chung zingah chuan tendon sheath cyst leh synovial bursae te pawh a tel. Tendon sheath cyst hi benign abnormalities a ni a, dense fibrous connective tissue leh mucus awmna a ni.

Popliteal cyst (chu chu baker’s cyst) hi taksaa synovial cyst awm tam ber a ni. Gastrocnemius muscle medial head leh Semimebranosus tendon inkar bursa atanga lo chhuak a ni. Popliteal cyst hi a tlangpuiin asymptomatic a ni a, mahse khup natna intra-articular disorder nen a inzawm fo thin.

Khup hma lamah common bursae pali a awm a. Suprapatellar bursa hi knee capsule nen a inhnaih a, rectus femoris tendon leh femur inkar ah a awm a, puitling tam zawkah chuan a khup ruh nen a traffic bawk. Prepatellar bursa hi patella hmalam chauh a awm a ni. Superficial infrapatellar bursa chu patellar tendon leh tibial tuberosity distal part aiin a chungnung zawk a, chutih laiin deep infrapatellar bursa chu patellar tendon distal part leh anterior tibial tuberosity inkar thuk takah a awm thung. Superficial bursa chu hman tam lutuk emaw, trauma emaw, hun rei tak khup na emaw, khup na lutuk structure-a hman tam lutuk chuan a ti na thei a, chu chuan deep infrapatellar bursa, repeated jumping emaw running ang chi te chu a ti hring thei a ni.

Khup chhunga medial aspect chu Goosefoot Bursa, Semimebranosus Bursa leh suprapatellar bursa te hian an thunun a ni. Goosefoot bursa hi lateral tibial collateral ligament tibial stop leh suture-a distal fusion tendons, thin femoral leh semitendinosus muscles inkar a awm a ni. Semimembranosus bursa hi Semimebranosus tendon leh medial tibial condyle inkar a ni a, suprapatellar bursa hi khup ruha bursa lian ber a ni a, patella chungah leh quadriceps muscle thuk takah a awm a ni.

05 Joint range of motion .

Active knee flexion tehna atan chuan damlo chu prone position assume tir la, a maximally flex la, chutiang chuan heel chu gluteal groove hnaih thei ang berah a awm ang Flexion angle pangngai chu 130° vel a ni.

Knee extension tehna tur chuan damlo chu thutna tur a ngaihtuah a, khup extension a tihpun theih nan. Straight leg emaw neutral position (0°) atanga khup tihzauh chu damlo thenkhat tan chuan thil pangngai a ni a, mahse hyperextension tia sawi a ni thung. 3°-5° aia tam lo tih overextension hi thil pangngai a ni. He range kaltlanga hyperextension hi knee retroflexion an ti a, abnormal presentation a ni.

Homas test hian quadriceps leh hip flexor te flexibility a test a.

Hip flexion contracture a awm chuan draping lower extremity thigh chu examining table nen flush emaw downward emaw aiin ceiling lam hawiin a angle ang.

Examination table-a hanging thigh angle hian hip flexion contracture degree a lantir a.

Quadriceps tightness a awm chuan drape hnuai lam chu examination table atang chuan a angle ang. Draping lower leg hmanga ground plumb line hmanga angle siam hian quadriceps tension degree a lantir a ni.

06. Joint stability a awm leh awm loh tehna .

Posterior Drawer Test - Posterior drawer test chu damlo chu supine position-ah, a natna vei hip chu 45°-ah a inthlak a, khup chu 90°-ah a inthlak a, ke chu neutral-ah a inthlak bawk a ni. Examiner chuan damlo proximal tibia chu kut pahnih hmangin circular grip-ah a man a, chutih lai chuan kut pahnih chu tibial tuberosity-ah a dah a. Chumi hnuah chuan proximal tibia-ah backward force an hmang leh a. Tibia hnung lam atanga tibia 0.5-1 cm aia tam leh a hnunglam atanga inthlak danglamna chuan a hriselna lam aiin a hnunglam atanga a inthlak danglamna chuan a hnung lama cruciate ligament chu a then emaw, a pum emaw a tear emaw a ni tih a tilang a ni.

Quadriceps Active Contraction Test - Damlo ke a ti nghet (a tlangpuiin kea a thut) chuan damlo chu examining table-ah ke hmalam pan turin a bei a (examiner kut resistance lakah), he maneuver hian quadriceps muscle a tikehsawm a, chu chuan posterior cruitate posterior-ah a tlem berah 2MM-a tibia a shift ang.

Tibial External Rotation Test - Tibial External Rotation Test hmang hian posterior lateral corner injury leh posterior cruciate ligament injury awmna te hriat theih a ni. Tibia hi pawn lam atanga passive takin 30° leh 90° a khup flexion ah a inher a. A natna vei lam chu a hrisel lam aiin 10°-15° aia tam a inher tam zawk chuan test chu positive a ni. Knee flexion 30°-a positive leh 90°-a negative chuan PLC hliam awlsam tak a awm tih a tilang a, 30° leh 90°-a positive chuan posterior cruciate ligament leh posterolateral complex-ah te hliam a awm tih a tilang bawk.

07. Thil chi hrang hrang (periarticular ligaments) .

Joint capsule ligament te pawh a awm bawk.

A rilru a buai em em a, a rilru a hah em em bawk a.

Intracapsular ligaments te pawh a awm bawk.

Anterior cruciate ligament, a hnung lam ligament te pawh a awm bawk.

Extracapsular ligament te pawh a awm bawk.

A rilru a buai em em a, a rilru a hah em em bawk a, a rilru a buai em em bawk a.

08. Joint-a innervation .

Neurovascular a awm dan .

Popliteal artery, popliteal vein, leh tibial nerve (sciatic nerve chhunzawm zel) awmna neurovascular bundle chu knee joint hnung lamah a kal a.

Peroneal nerve hman tlanglawn ber chu sciatic nerve lateral branch a ni.

09. A kaihhnawih ruhte .

Anterior lateral .

Quadriceps-ah hian Rectus femoris, vastus medialis, vastus lateralis, leh intermedius femoris te a awm a.

posterior lam .

Hamstrings 1000 a ni.

biceps femoris, semitendinosus leh semimembranosus te a huam a;

gastrocnemius a ni.

Anteromeal 1000 a ni.

Tibialis hmalam a ni.

Khup ruh inzawmna nghet tak vawng rengtu muscle te, quadriceps, suture muscles, hamstrings, thin femoral muscles, biceps femoris, semitendinosus, leh semimembranosus te pawh a awm.

10. Taksa enfiahna .

1. Hmuh theiha enfiah .

Damlo lam leh a sir lehlamah khup ruh inzawmna leh symmetry enfiah la, localized swelling, vun rawng pangngai lo, leh kal dan pangngai lo, etc. te chu ngaihven rawh

2. Palpation 1000 a ni.

A natna leh a hringna hmun, a thuk zawng, a zau zawng leh a nature te chu a theih ang angin a natna lam hawiin a awm leh awm loh enfiah rawh.

3. Mobilization .

Damlo active leh passive activities hmangin knee joint mobility enfiah thin ang che.

4. A tehna .

Limb segment tin sei zawng bakah a sei zawng zawng, a ke ruh vel, a ruh inzawmna range, taksa chakna, sensation area hloh, etc. te teh la, record leh marking siam rawh.

5. A bik taka enfiahna .

 - Floating Patella Test: Damlo khup ruhah effusion a awm leh awm loh enfiah rawh.

A kalphung enfiah .

Suprapatellar bursa chu tui a punkhawm theih nan a hrual hnuah, knee joint-ah fluid a awm chuan patella chu index finger hmangin zawi zawiin a press a, pressure a chhuah veleh chuan patella chu fluid buoyant force hnuaiah chunglam hawiin a float ang a, pressure a chhuah chuan patella chuan popping emaw float emaw a nei ang a, chu chu buoyant force-te avang a ni ang.

- Drawer Test: Cruciate ligament a chhiatna a awm leh awm loh enfiah.

Anterior Drawer Test: Damlo chu khumah a flat a, khup flexion 90 °, ke chu khumah a flat a, a hahdam hle. Examiner against the patient’s feet to make it fixed, kut chuan khup ruh tibial tawp chu a chelh a, a hma lamah bawnghnute chu a hma lamah hrual la, tibia anterior displacement chu 5mm a tha zawk a nih chuan positive a ni a, positive chuan anterior cruciate ligament injury chu a tarlang a ni (Note: Lachman test hi knee flexion 30 °-a anterior drawer test a ni).

Posterior drawer test: Damlo chu a hnungzang ah a mu a, khup chu 90°-ah a ben a, a kut pahnih chu khup ruh hnung lamah a dah a, kutpui chu extensor lam hawiin a dah a, calf proximal end chu hnunglam hawiin a nawr leh a, Tibia chu femur-ah hnunglam hawiin a kal a, chu chuan posterior-in a then chu a then chu a let leh a, chu chu a then chu posterior-in a sawi a, chu chu a then chu a let leh a ni.

- Grinding Test: Khup meniscus chhiatna a awm leh awm loh hriat chian nan.

Knee joint grinding test: Lateral collateral ligament leh meniscus injury a awm leh awm loh enfiah nan taksa enfiahna hmanrua.

Damlo chu a khup natna chu 90°-a flexed-in prone position-ah a awm a.

1. Rotational Lifting Test 1000 a ni.

Examiner chuan damlo kawrfual chungah bawnghnute chu a hmet a, a kephah chu a kut pahnih hmangin a chelh a, chu chuan bawnghnute chu a longitudinal axis-ah a chawi sang a, chutih lai chuan chhung lam leh pawn lam inherna a ti a Khup sir lehlamah natna a awm chuan lateral collateral ligament injury a nih rinhlelh a ni.

2. Rotary compression test 1000 a ni.

Examiner chuan a ke ruh natna ke chu a kut pahnih hmangin a chelh a, chutiang chuan a khup natna chu 90°-ah a flex a, calf chu dinglam hawiin ke chu chunglam hawiin a awm a ni. Chumi hnuah chuan khup ruh chu hnuai lam hawiin hrual la, a rualin bawnghnute chu chhung lam leh pawn lam hawiin rotate rawh. Knee joint chhung leh pawn lam natna a awm chuan a chhung leh pawn meniscus a chhiat thu a tarlang a ni.

Khup chu extreme flexion-ah a awm a nih chuan posterior horn meniscus rupture chu rinhlelh a ni a; 90°-ah a nih chuan intermediate rupture rinhlelh a ni a; Straight position hnaih laiin natna a awm chuan anterior horn rupture a awm nia rinhlelh a ni.

- Lateral stress test: Damlo chu lateral collateral ligament a chhiat leh chhiat loh enfiah.

Lateral knee stress test hi taksa enfiahna a ni a, khup lateral collateral ligaments enfiah nan hman a ni.

Position: Damlo chu examination bed-ah supine-in a mu a, a ke ruh natna vei chu a ke hnuai lam a vei chu khum pawnah dah a nih theih nan zawi zawiin an paih a ni.

Joint position: Khup chu fully extended position-ah dahin 30° flexed position-ah dah a ni.

Force Application: A chunga khup position pahnih ah hian examiner chuan damlo ke hnuai lam chu a kut pahnih hmangin a chelh a, medial leh lateral side ah te stress a apply ve ve a, chutiang chuan khup ruh chu passive takin abducted emaw adducted emaw a ni a, chu chu valgus leh valgus test te chu an ti a, healthy side nen an khaikhin a ni.

Stress application process laiin khup ruhah natna a awm a nih chuan, emaw, inversion leh eversion angle chu normal range atanga chhuak a nih a, popping sensation a awm chuan lateral collateral ligament sprain emaw rupture emaw a awm tih a tilang a ni. External rotation stress test a positive chuan medial straight direction chu a nghet lo tih a tilang a, medial collateral ligament, medial meniscus leh joint capsule te pawh a awm thei a Internal rotation stress test a positive chuan lateral straight direction chu a nghet lo tih a tilang a, lateral meniscus emaw articular surface cartilage emaw hliam a awm thei bawk.

11. Khup chhinchhiah dan .

1. X-ray hmanga enfiah .

Fracture leh degenerative osteoarthropathy awm leh awm loh enfiah nan hman thin a ni. Weight-bearing (standing) position knee joint hma leh sir lam view film hian ruh, khup ruh gap leh a dangte a en thei a ni.

2. Tomography (CT) chhiar chhuah a ni.

CT scan hian ruh harsatna leh ruh tliak fiah lo tak takte hriat theihna a pui thei a ni. CT scan chi khat bik chuan gout chu dik takin a hre thei a, joint chu a inflamed lo a nih pawhin.

3. Ultrasound 1000 a ni.

Sound wave hmangin khup chhung leh a chhehvela soft tissue structures te chu real-time image a siam thin. Ultrasound hian pathologic changes te, ruh mastoids te chu joint margins ah te, cartilage degeneration, synovitis, joint effusiona, popliteal fossa swelling, leh meniscal bulging te a hmu thei a ni.

4. Magnetic Resonance Imaging (MRI) 1.1.

He test hian soft tissue hliam, ligaments, tendons, cartilage leh muscles te a hriat theih nan a pui a ni.

Laboratory Tests: Doctor chuan infection emaw inflammation emaw, thisen test leh a chang chuan arthrocentesis° a rinhlelh chuan, laboratory analysis atan khup ruh atanga tui tlemte paih chhuah a ngai mai thei.

12. Joint natna thlentu tlangpui .

1. Hliam tuar te nena inzawm .

ligament hliam, anterior leh posterior cruciate ligament leh lateral collateral ligament strains leh tears te; meniscus hliam tuar; Patellar tendonitis leh mittui tlakna; ruh tliak leh a dangte.

2. Arthritis nena inzawm .

osteoarthritis hi joint cartilage a chhe leh a tear vang a ni a; Rheumatoid arthritis hi immune system-in ruh inzawmna a beih vang a ni a; Gout hi joint-te nghawng thei uric acid sang tak atanga crystals lo awm vang a ni.

3. A chhan dangte .

synovitis hian ruh natna leh hliam a thlen a; Patellar-a harsatna awmte, dislocation leh cartilage wear te; tumor invading joint; Edema hi a lo chhuak a, a hring a, a hring a, a hring a, a hring a, a hring a, a hring a, a hring a, a hring a. hun rei tak chhung dinhmun tha lo tak tak; Iliotibial fascia syndrome hi friction repetitive avanga lo awm a ni a, chu chuan khup pawnah natna a thlen thin.

13. Enkawlna hman tlanglawn .

1.Conservative hmanga enkawlna .

-Rest leh braking .

-Coll leh hot compress te a awm bawk.

-Drug Therapy 1000 a ni.

-Tisa hmanga enkawlna .

-Exercise hmanga enkawlna .

-Assistive device hman dan .

2.Surgery .

-Arthroscopic surgery tih a ni.

-Arthroplasty 1000 a ni.

3.Thawhrimna dang .

-Traditional Chinese damdawi (TCM) .

-Injection hmanga enkawlna .