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Congenital Limb Length Discrepancies

Congenital Limb Length Discrepancies

Limb deformities can be congenital (present at birth) or develop at a later stage because of a fracture, infection, arthritis or tumor.

Acquired Limb Length Discrepancies

Acquired Limb Length Discrepancies

Adult leg length discrepancy is a condition in which an individual’s legs are of unequal length with one leg shorter than the other. This can occur as a result of fractures or bone diseases.

Bowed Legs

Bowed Legs

Bowed leg is a bony deformity resulting in outward curvature of one or both knees of the lower legs. It is commonly seen in toddlers and overweight adolescents.

Knocked Knees

Knocked Knees

Knock knees, also called genu valgum, is a type of angular knee deformity in which the legs curve inwards at the knees. It usually affects children in the age group of 3-4 years. The condition may correct itself as the child grows to the age of 7 to 8 years.

Patellar Instability

Patellar Instability

Any damage to the supporting ligaments may cause the patella to slip out of the groove either partially (subluxation) or completely (dislocation). This misalignment can damage the underlying soft structures such as muscles and ligaments that hold the kneecap in place.

Patellar Dislocation

Patellar Dislocation

Any damage to the supporting ligaments may cause the patella to slip out of the groove either partially (subluxation) or completely (dislocation).

Knee Pain

Knee Pain

Knee pain is a common condition affecting individuals of various age groups. It not only affects movement but also impacts your quality of life. An injury or disease of the knee joint or any structure surrounding the knee can result in knee pain.

Knee Angular Deformities

Knee Angular Deformities

Angular deformities of the knee are variations in the normal growth pattern during early childhood and are common during childhood.

Jumper's Knee

Jumper's Knee

Jumper’s knee, also known as patellar tendinitis, is inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in the extension of the lower leg.

Iliotibial Band Syndrome

Iliotibial Band Syndrome

An iliotibial band is a tough group of fibers that runs from the iliac crest of the hip along the outside of the thigh, till the outer side of the shinbone, just below the knee joint.

Knee Fracture

Knee Fracture

A fracture is a condition in which there is a break in the continuity of the bone. In younger individuals, these fractures are caused by high energy injuries, as from a motor vehicle accident.

Fractures of the Tibia

Fractures of the Tibia

The lower leg is made up of two long bones called the tibia and fibula that extend between the knee and ankle. The tibia or shinbone is the larger of the two bones. It bears most of the body’s weight and helps form the ankle joint and knee joint.

Fractures of the Patella

Fractures of the Patella

The patella or kneecap is a small bone present in the front of your knee where the thigh bone meets the shinbone. It provides protection to your knee and attachment to muscles in the front of the thigh.

Patellofemoral Instability

Patellofemoral Instability

Patellofemoral instability means that the patella (kneecap) moves out of its normal pattern of alignment. This malalignment can damage the underlying soft structures such as muscles and ligaments that hold the knee in place.

Quadriceps Tendon Rupture

Quadriceps Tendon Rupture

The quadriceps can rupture after a fall, direct blow to the leg and when you land on your leg awkwardly from a jump. Quadriceps tendon rupture most commonly occurs in middle-aged people who participate in sports that involve jumping and running.

Patellar Tendon Rupture

Patellar Tendon Rupture

The patellar tendon works together with the quadriceps muscle and the quadriceps tendon to allow your knee to straighten out.

Patellar Tendinitis

Patellar Tendinitis

Patellar tendinitis, also known as "jumper's knee", is an inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in extension of the lower leg.

Unstable Knee

Unstable Knee

Damage to any of these supportive structures causes instability of the knee joint. An unstable knee can be caused by the sudden twisting of the knee, tears of the meniscus, ligament or capsule, osteoarthritis of the knee (wear and tear of the cushioning cartilage tissue between the bones) and sports injuries.

Tibial Hemimelia

Tibial Hemimelia

Tibial hemimelia also called tibial deficiency is a rare birth defect affecting the lower limbs, particularly beneath the knee. In this condition, the child is born with a shorter than normal or missing tibia (shinbone).

Fibular Hemimelia

Fibular Hemimelia

Fibular hemimelia is a rare birth defect affecting the lower limbs, particularly beneath the knee. In this condition, the child is born with a shorter than normal or missing fibula (calf bone).

Congenital Absent Patella

Congenital Absent Patella

Congenital absence of the patella is a rare condition in which the kneecap does not form or is abnormally small. It does not usually affect the functioning of the knee but may sometimes cause pain, deformity of the limb, and difficulty with movement.

Congenital Knee Fusion

Congenital Knee Fusion

The knee joint is sometimes found to be fused at birth due to a developmental disorder. Congenital knee fusion, also called congenital synostosis of the knee, is a very rare condition that alters the structure of the limb and affects function.

Congenital Pseudoarthrosis of the Tibia

Congenital Pseudoarthrosis of the Tibia

Congenital pseudoarthrosis of the tibia is a rare condition that usually occurs in the first 2 years of life. In this condition, the tibia or shinbone is weak and undergoes fractures spontaneously or due to minor injury.

Traumatic Limb Salvage Surgery

Traumatic Limb Salvage Surgery

Limb salvage surgery, also called limb-sparing surgery, is a surgical procedure that involves debridement- removal of the injured bone and surrounding tissues and reconstructing them into a functional limb.

Knee Arthroscopy

Knee Arthroscopy

Knee arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to diagnose or treat a knee problem.

Knee Fracture Surgery

Knee Fracture Surgery

A knee fracture is a broken bone or a crack in or around the joint of the knee. This can involve the tibia (shin bone), the kneecap (patella), or femur (thighbone) where they connect with the knee.

Knee Ligament Reconstruction

Knee Ligament Reconstruction

Knee ligament reconstruction is a surgical procedure to repair or replace damaged ligaments of the knee joint. The surgery can be performed using minimally invasive techniques.

Knee Osteotomy

Knee Osteotomy

Knee osteotomy is a surgical procedure in which the upper part of shinbone (tibia) or lower part of thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only one side of your knee.

Patellofemoral Stabilisation

Patellofemoral Stabilisation

Patellofemoral stabilization is a broad term that refers to surgeries employed for stabilization (prevention of dislocation) of the patella for the treatment of patellofemoral instability.

Patellofemoral Realignment

Patellofemoral Realignment

Patellofemoral realignment is a surgical procedure performed to treat symptomatic patellofemoral instability that does not respond to nonsurgical treatment measures.

Patellar Tendon Repair

Patellar Tendon Repair

Patellar tendon repair is the surgery performed to reattach the torn tendon to the kneecap and to restore normal function in the affected leg.

Quadriceps Tendon Repair

Quadriceps Tendon Repair

Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg.

Physical Therapy for Knee

Physical Therapy for Knee

Physical therapy is an exercise program that helps you to improve movement, relieve pain, encourage blood flow for faster healing, and restore your physical function and fitness level.

Knee Anatomy

The knee is a complex joint made up of different structures - bones, tendons, ligaments, and muscles. They all work together to maintain the knee’s normal function and provide stability to the knee during movement.

Having a well-functioning healthy knee is essential for our mobility and ability to participate in various activities. Understanding the anatomy of the knee enhances your ability to discuss and choose the right treatment procedure for knee problems with your doctor.

Bones of the Knee

The knee is a hinge joint made up of two bones, the thighbone (femur) and shinbone (tibia). There are two round knobs at the end of the femur called femoral condyles that articulate with the flat surface of the tibia called the tibial plateau. The tibial plateau on the inside of the leg is called the medial tibial plateau and on the outside of the leg, the lateral tibial plateau.

The two femoral condyles form a groove on the front (anterior) side of the knee called the patellofemoral groove. A small bone called the patella sits in this groove and forms the kneecap. It acts as a shield and protects the knee joint from direct trauma.

A fourth bone called the fibula is the other bone of the lower leg. This forms a small joint with the tibia. This joint has very little movement and is not considered a part of the main joint of the knee.

Articular Cartilage and Menisci of the Knee

Movement of the bones causes friction between the articulating surfaces. To reduce this friction, all articulating surfaces involved in the movement are covered with a white, shiny, slippery layer called articular cartilage. The articulating surface of the femoral condyles, tibial plateaus and the back of the patella are covered with this cartilage. The cartilage provides a smooth surface that facilitates easy movement.

To further reduce friction between the articulating surfaces of the bones, the knee joint is lined by a synovial membrane that produces a thick clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule.

Within the knee joint, between the femur and tibia, are two C-shaped cartilaginous structures called menisci. Menisci function to provide stability to the knee by spreading the weight of the upper body across the whole surface of the tibial plateau. The menisci help in load-bearing i.e. it prevents the weight from concentrating onto a small area, which could damage the articular cartilage. The menisci also act as a cushion between the femur and tibia by absorbing the shock produced by activities such as walking, running and jumping.

Ligaments of the Knee

Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral and cruciate ligaments.

Collateral ligaments are present on either side of the knee. They prevent the knee from moving too far during side to side motion. The collateral ligament on the inside is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL).

Cruciate ligaments, present inside the knee joint, control the back-and-forth motion of the knee. The cruciate ligament in the front of the knee is called anterior cruciate ligament (ACL) and the cruciate ligament in the back of the knee is called posterior cruciate ligament (PCL).

Muscles of the Knee

There are two major muscles in the knee - the quadriceps and the hamstrings, which enable movement of the knee joint. The quadriceps muscles are located in front of the thigh. When the quadriceps muscles contract, the knee straightens. The hamstrings are located at the back of the thigh. When the hamstring muscles contract, the knee bends.

Tendons of the Knee

A tendon is a tissue that attaches a muscle to a bone. The quadriceps muscles of the knee meet just above the patella and attach to it through a tendon called the quadriceps tendon. The patella further attaches to the tibia through a tendon called the patella tendon. The quadriceps muscle, quadriceps tendon, and patellar tendon all work together to straighten the knee. Similarly, the hamstring muscles at the back of the leg are attached to the knee joint with the hamstring tendon.

  • American Osteopathic Association
  • Washington University in St. Louis
  • Inspira Health
  • Paley
  • Midwestern University Chicago College of Osteopathic Medicine
  • AOBOS
  • MHE Research Foundation
  • Limb Lengthening and Reconstruction Society
  • David S. Feldman, MD