Sinovial sheath of the knee joint. Trim joints

Date: 04.03.2020

The joint is formed by the summers of the femoral and tibial bones and the patella. The articular surfaces of the bones are almost all over a cartilage. Between the joint surfaces, there are special cartilaginous men's mysteries that are connected by the outer surface with the joint capsule; Of these, the external shape of the letter O, the inner - the letters S. Both meniscus are interconnected by lig. TransVersum Genus..

IN boundament The joint includes the following bundles: intra-articular and embracing.

Coffee bundles:

front and rear cruciform ligaments (Lig. Cruciatum Anterius ET Posterius) - Connect the poor and tibia bones.

Emnoting bundles:

bunch of Padnanel (Lig. Patellae);

medial and lateral supporting bundles of the patella;

collateral tibial bunder (Lig. Colladerale Tibile) Strengthens the joint from the medial side (fucked with the joint capsule and the medial meniscus, so the bundle is accompanied by damage to the articular capsule and the gap of the meniscus);

collateral Maloberstovy Bunda (Lig. Colladerale Fibulare) Strengthens the joint capsule from the lateral side;

kosy and arcuate patent ligaments (Lig. Popliteum Obliquum et Lig. Popliteum Arcuatum) Strengthen the capsule from behind.

At the places of transition of the synovivial shell on the bone, components of the knee joint, are formed, which significantly increase the body cavity, and in inflammatory processes, there may be places of blood cluster, pus, serous fluid.

There are 9 crochets (5 in front and 4 days):

upper (Recessus Genus Superior) - between the thigh and the patella;

front Upper Westerns - Medial and Lateral (Recessus Genus Anteriores Superiores Medialis et Lateralis)

front Bottoms - Medial and Lateral (Recessus Genus Anteriores Inferiores Medialis ET Lateralis) - between the menisci and the tibia mysteries;

rear Upper Westerns - Medial and Lateral (Recessus Genus Posteriores Superiores Medialis Et Lateralis) - between the sutures of the hips and menisci;

rear lower worships - Medial and lateral (Recessus Genus Posteriores Inferiores Medialis et Lateralis) - Between the menisci and the Matriot Bones.

Blood supply:

The knee joint is bustling with numerous arteries, which, anastomosing, form a knee articular network (Rete Articulare Genus):

downward knee artery (a. Genus Descendens) from the femoral artery (coming out of the leading channel);

five branches of the patellied artery (lateral and medial top knee, medium knee, lateral and medial bottom knee artery);

return branches of the front tibial artery: front and rear tibial return arteries (AA. Reccurrentes Tibiales Anterior et Posterior);

aRTERIYA, CUTTING BACK (a. CircumFlexae Fibulae) From the rear tibial artery.

Innervation:

The innervation of the knee joint is carried out by the branches of the total small (N. Peroneus Communis), TBIBERS (N. Tibalis) and subcutaneous nerves (N. SAPHENUS).

Sinovial bags in the knee joint

In the front area of \u200b\u200bthe knee in the subcutaneous tissue and near the attachment points of the tendons there are a large number of synovial bags.

Above the patella, between the four-headed muscle and the femoral bone there is a harvesting bag (bursa suprapatellari.s). It is reported to the upper corner of the knee joint.

The following pre-trained bags are located ahead of the patella (none of them communicates with the scene of the joint):

subcutaneous (bursa prepatellaris subcutanea) - between superficial and wide fascia;

subfascial (bursa prepatellaris subfascialis) - between the wide fascia and the tendon of the four-headed muscles;

dossochivaya (bursa prepatellaris subtendinea) - between the tendon of the four-headed muscles and the periosteum.

Book from the patella at the level of the bugness are the sublovers of subcutaneous and deep bags (BB. Infrapatelles Subcutanea et profunda)They do not communicate with the cavity of the joint.

With the cavity of the joint, there are bags that are at the back of the hip syslovka: the bag of popliteal muscles (b. m. poplitei) (Reported with the rear upper lateral breakdown), medial docking bag of calf muscle (b. Subtendinea m. Gastrocnemii Medialis) and the bag of semi-recreak muscle (bursa m. semimembranosi) Open in the rear upper medial corpure.

Point points

Puncture is produced at the level of the foundation or top of the patella, retreating from it by 1-2 cm.

The anatomy of the knee joint (Sinelnikov R. D. and other authors consider it enough in detail) is quite complex. This articulation in the human body consists of many parts. The compound takes on the most complex loads, distributing the weight, several times higher than its own. The complexity of the joint is due to its components. These are the biggest bones of the lower limbs.

3 bones participate in the formation of the joint. They are connected by a powerful joint apparatus, which includes a joint capsule, ligaments and synovial bags. The entire joint is driven by foot muscles.

The structure of the knee joint

The knee consists of three bones, muscles providing its movement, nerve endings and blood vessels, meniscus, cross-shaped ligaments. Such a complex structure is due to high loads. Provides maximum convenience when moving on 2 limbs. Primates the structure is much easier due to the presence of 4 limbs.

The arcuate patent bundle also participates in the hold of the patella. It starts from the femoral and mulberry bones, and is attached to the tibial. The bunch and begins, and ends on the lateral sumpers.

The transverse bunch of the knee connects the meniscus along their front surface.

Anterior meniscriced bundle originates from the forefront of the internal meniscus, follows and the dodder, to the lateral satellum of the thigh.

The rear menescript bundle originates from the rear edge of the external meniscus, follows and inside, to the medial disinth of the thigh.

The mysterious knee joint works as a block-shaped, being in a dispere position. The anatomy of the knee joint allows you to rotate the vertical axis in the bent position.

Capsule Sustav

The articular capsule is attached to all three bones involved in the formation of the joint.

To the thigh bone, the fastening occurs under the screws, to the tibial - along the articular surface, to the patella - along its articular surface.

The synovial membrane covers the combined surfaces of the bones to the cartilage and wipes the cross-shaped ligaments. In addition to the smooth structure of the membrane, there are many synovial porcers and folds.

The most developed folds are wonderful. They go on the sides of the patella up. And contain a sublovers of the fat body between their sheets.

The sublovered synovial fold lies below the bone itself, is a continuation of the wingid folds. It takes its beginning above the patella, goes to the body cavity, fastened on the front edge of the pits, between the soothers of the femoral bone.

Sinovial Bags of Knee Sustain: Anatomy and Building

The knee joint capsule forms several synovial bags. They can be in various places of muscles and tendons, clutching inside and between them. Sinovial bags can be among the bones and ligaments.

The tendon of the 4th head of the thigh muscle and the front surface of the patella form a docking pre-train bag among themselves.

The bunch of the patella and the tibia is formed among themselves a deep pebel synovial bag. Sometimes it has a connection with the cavity of the knee joint and separated from it a layer of fatty fiber.

These are the largest knee joint.

Goose paw of the knee joint: anatomy and location

For the normal operation of the knee joint, there are a number of muscles that can be divided by their location:

The front surface of the hip is a four-on muscle.
The back surface of the hip is a double-headed muscle, semi-dry, semi-proof.
The inner surface of the hip is large, thin, long, short, leading muscles, creamy muscle.

There is a place on the shin where 3 thigh muscles are attached - tailoring, semi-dry and thin. In this place, a goose paw is formed, where the synovial bag is located.

Grass Knee Sustava

Knee injury - very frequent phenomenon. In order to diagnose the cause of the joint pain, the doctor very often appoints MRI. The anatomy of the knee joint (bone, ligaments, muscles, artery, etc.) is visible in the picture, which will determine what cause is unpleasant sensations.

Very often knee injuries receive athletes, as well as those who have work related to physical labor. In order to reduce the risk of injury to the knee joint, it is necessary to regularly strengthen muscles and ligaments. Perform simple exercises from the articular gymnastics, regularly drink vitamin and mineral complexes. All these measures contribute to the strengthening of the knee joint and muscles leading to move.

The complex structure of the knee causes the execution by the person's rotational, flexing and minimum lateral movements, promotes the correct redistribution of body weight at the foot. Under the influence of significant loads, the joint is often subjected to damage. The presence of basic knowledge by its structure and biomechanics will help on time to recognize the symptoms of developing diseases.

Anatomical features

The articulation under consideration is included in the group of the largest moving elements of the ODA. In form, it refers to the mystery, in accordance with the type of structure - to complex, complex.

The main links forming the knee joint are a patella, epiphysis of long tubular bones (femoral and tibial).

In the list of additional structures - bundles, meniscus, the formation of a synovial shell. Among the latest are bags, folds (including fat). Playing auxiliary components provide the necessary intermittent mobility, depreciation.

The anatomy of the knee joint does not include a small bone: the segment belongs to the links of the ODA forming the shin.

The nature of the joint movements is determined by having differences of the parameters of the curvature of the mysteries of the largest element of the skeleton of a person.

When the shin is straightened, it is possible to flexing limbs to 130º. Further change in position is carried out by pressing the external surfaces of the formation of the locomotor system.

The highest degree of rotation of the bottom of the leg is available when the joint bent at 65-70º.

The outer rotation can be produced by 40º, internal - by 10º. An increase in the volume of the specified type of movement prevents the buys ligaments.

The amplitude of bringing, the lead is insignificant; It is performed only after flexing the limb in the area under consideration.

Epiphyshes of the femoral and tibial bones

In the formation of the articulation, epiphesies of the femoral, tibial bones are involved. The end departments are first formed intermittent compound from above, the second is from below. The articular surfaces of the structures are covered with cartilage and have a different form - convex and concave, respectively. The coincidence of the configurations of the links provides meniscus.

Thickening epiphydes are called sumpers (internal - media, outdoor - lateral).

the protrusions are partially available to palpation. The study of healthy elements by feeling does not cause unpleasant sensations. The appearance of discomfort during manipulation is a symptom of the development of the disease.

The mysteries of the femoral bone are contacted with the surface of the tibial element of the ode - the Target Plateau. Education consists of 2 parts - lateral, medial.

Knee cap

The knee structure includes a pea having a shape of a concave from the inside and slightly convex from the outside of the triangle with rounded corners. Anatomical formation is located on the front of the articulation, inside the combining head of the chip of the thigh tendon.

The link is the largest seasonal bone.

In the structure of the patellae allocate:

the base is the top edge;
top (bottom elongated part);
2 surfaces - the front and rear (the first is covered with periosteum, the second - hyalinic cartilage).

The articular side of the formation is divided by vertical scallop for 2 unequal shares - the medial (it has a smaller area), lateral.

In the list of functions of the knee cup:

Preservation of intermittent articulation from injuries.
Increasing the efforts created by the thighs of the thigh with the extension of the leg.
Protection of surfaces of tubular bones from offsets to the sides

Cartilage and menissi

By its structure, the knee joint represents a complicated scheme, a special place in which the type of connective tissue is occupied.

Education is performed by several important functions. In their list:

depreciation of shock loads;
protection of articulation structures from abrasion, deformations;
ensuring stability and proper operation of a stripe connection.

Hyalin cartilage

The described elements cover the thickening of bone epiphysis. Visually, they resemble matte glass; Consist of large oval cells - chondrocytes. The latter are (groups, isolated) in the lacunas of the cartilaginous matrix - a special intercellular substance, the components of which are collagen, glycoproteins, elastin, proteoglycans and proteins of non-core origin.

The formation is subject to damage - mechanical pathological. The development of the disease is evidenced by the appearance of clicks, crunch, pain when walking.

Menisky

Dense, solid connecting elements that differ from the elevated presence in the structure of the network of collagen fibers. They are located between the Target Plateau and the poor tubular link of the skeletal musculoskeletal system.

Change your form in accordance with the age of a person: newborn education has a disk appearance, as the child grows the central part of the tissue is atrophy and acquires a C-shaped configuration. The softening of meniscus structures is observed in persons over 60 years.

According to the anatomy of the knee structure, the flat intra-articular cartilage elements of the compound are divided into internal and lateral. Medical links are less mobile, are more often traumatized by nearby bones.

In the structure of formations allocate the middle part (body), horns (front, rear).

The peripheral edges of the components under consideration are thickened, attached to the articular capsule; Free - directed towards the center of articulations.

In the structure of the knee separately allocated ligaments of meniscus; Read more about them below.

Sustain cavity

A closed space having a sliding configuration. Limited by surfaces forming bone element, cunning tissue shell. Filled with synovial fluid.

The minimum capacity of the formation with a bent leg is 75 cm³. In women, the maximum capacity of the knee of the knee reaches 130 units. The capacity of the considered space of the lower limbs among male representatives by 20 more.

Capsule of the knee joint

The formation is a connective tissue plate. It is distinguished by density, strength. Element, clutching bone epiphysis, forms a closed articulation cavity.

The knee capsule consists of 2 membranes (internal and outer), characterized by the structure and functions.

The first one is a synovial shell. Its components are elastic and collagen beams, flat cells.

The layer covers all the links of the articulation (with the exception of the cartilage), has an inhomogeneous structure.

In the structure of the membrane allocate:

Carnations, or a series of protruding. The greatest magnitude is distinguished by 2 rear side, front medal.
Fat fabric folds.
Small vile, the number of which may vary.

Among the most significant functions of the shell - the implementation of the depreciation of the compound, the provision of biomoshtics and nutrition, the synthesis of sufficient synovial fluid (the elastic mass produce epithelial cells), improving the mobility of epiphysis.

The second membrane belonging to the structure of the articular capsule of the knee joint is a fibrous layer. He swears the education under consideration outside. It consists of connecting loose tissue, elastic and collagen fibers. The formation protects the stripe compound from external damage and penetration of pathological agents.

Bags of the knee joint

These elements are separated separately in the knee joint. Sinovial bags are cavities of a flattened configuration with varying dimensions. They are filled with a special fluid. Special capsules are degrading education from the surrounding links.

Are the development of pathological processes of the articular bags of knee joints is exposed, is positive. The most common diseases include bursites (inflammation). They manifest themselves pain, swelling in the field of articulation.

Bags of the knee joint are predominantly between and near the connecting formations, under the muscles. In the list of functions they perform - protection of internal links of articulation from damage and ensuring their natural movement, reducing friction.

The composition of the intermittent compound combines several types of segments under consideration. They are characterized by topography, configuration, sizes. The structure of the liquid contained in the cavities is not identical. In a substance of elements that do not exit a sliding space, there are no morphological signs of synovia.

Brief characteristics

Among the most significant synovial bags of the knee joint:

Harmonic breakdown. Located above the patella. The location is between thickens of the epiphysis of the thigh and the tendon of the quadriceps. The structure varies with the formation of a human body.
Deep sublitty. It is located between the epiphysis of the tibial tubular link of the ODA and the bunch of seamovoid bone. Differs oval form. Not reported to the articular cavity.
Semi-stepped muscle. Received in 20% of people. By configuration, the bag is similar to the elongated oval. In half of the cases, it is reported with a slit articulation space.
Subcutaneous pre- and podnodelnikovy. Received in 50-60% of the surveyed. Provide the elastic support of the seamovoid bone and its ligaments.
Goose paws. Education is predominantly oval. It is reported with the oral cavity in 30% of cases. Slides under tenders of fine, tailoring and semi-chest muscles on a collateral bunch of tibia. The walls of the formation consist of a synovial membrane.

It is forbidden to test inflammation of the considered elements at home without prior consultation with the doctor: progressive pathological processes may cause disability.

The structure of ligaments of the knee joint

The anatomy of the structure of the knee joint includes bundles, or ligaments. They ensure the stability of the system and the accuracy of the movement.

Elements are structures (chips) from connective tissue. Attach to the bones using special fibers.

In the structure of ligaments of the knee joint, proteins are dominated - collagen, elastin. Elasticity, the flexibility of the formations is reduced by man reaching 2 of the period of mature age. Ligaments are subject to various types of injury - stretching, breaking. The presence of damage is evidenced by the restriction of motor activity.

At the place of finding education is systematized on outside and intra-articular.

Intra-articular connecting structures

The group combines 2 cruciform ligaments covered with synovial membranes - rear, front.

Medical impact of the thigh and the rear intermaceric field of the tibial tubular segment of the sides of the attachment of the first of the listed formations. The second connects the inner surface of the lateral protrusion of the epiphyse and the front intermaccine field of the above links of the locomotor system.

The main functions of ligations are the stabilization of the joint, the preventing displacement of the femur-back-back relative to the leg.

Bundles Menishov

In the structure of the knee joint, a healthy person is distinguished 2 types of elements: menisco femur and transverse ligaments.

The first are systematized on the back and front, connect the cartilage links with the soot of the femoral bone. Their appearance is due to the need to make rotational movements in articulation. The results of research in the field of physiology indicate: the frequency of cases of detection of underdevelopment of the segments under consideration increases. This is due to a decrease in the amplitude of the rotation of the strength compounds from a modern person.

The transverse bunch of the knee is a structure connecting the front edges of the lateral meniscus and inner cartilage formation. Provides their stability with respect to the mysteries in different phases of movement. Its appearance is associated with the development of straightening. The ligator is present in 65% of the surveyed.

Empting elements

Feature of the anatomy of the knee joint - the presence of handbag and collateral ligaments.

The latter includes 2 types of tight seaside - low and tibia. They stabilize the articulation, prevent the displacement of tubular long bones in the side plane. Each consists of two zones - deep and surface, front and rear, respectively.

A group of handbag ligaments combines oblique and arcuate patellied ligaments. The second of the listed begins on the lateral dish of the hip and passes to the similar link of the tibia. Strengthens the back of the joint. Consists of 2 departments - outdoor and internal. Its median region is fastened with the continuation of the semi-membrane tendon - obliquely patelled bundle. The latter connects the internal solar dice with the lateral thickening of the hip epiphyse.

For the stabilization of the position of the largest sesamoid formation, the bunch of a patella formed by the tendons of the quadriceps is responsible.

Muscles of the knee

The muscles of the knee joint provide the right feature function.

All compound muscles are differentiated taking into account the topography and the functions performed on 3 categories. In their list:

Front band. Combines the quadriceps (the most powerful structure) and the tailoring (longest) formation. Elements are thigh flexors. Experts include the category also the articular muscle of the knee, whose basic function is the displacement of the joint capsule (in order to avoid its infringement).
Rear group. It includes a double-headed, semi-dry, semi-seamless structure. Muscles belong to the extensors of the hip joint, shin flexors in the knee joint. Elements pass through 2 of the listed articulations, limit the populated hole on top.
Internal (medial) group. The category combines a comb and thin structure, as well as 3 types of leading muscles (long, short, greater). The cutting of the muscle contributes to the note of the hips of the lower limbs, turning the leg to the outside and flexing it in the area of \u200b\u200bthe knee, turning the dust of the proximal part of the leg.

All listed formations consist of muscle tissue, the main part of which is represented by myocytes.

Innervation and blood supply to the knee

The elements that ensure the innervation of the knee joint are branches of the thick nerve of the human body - the sedlication. Education is divided into the field of the poplitea (less often - at the sacratling plexus) on 2 parts - more and smallcoma. They provide the sensitivity of the posterior, the front parts of the leg, respectively.

The scheme of the location of the above structures repeats the network of large blood vessels.

The blood supply to the knee joint is carried out with the help of the branches of the popliteal artery. In their list:

Lateral and medial tops supplying double-headed and wide femoral muscles.
Average. On it, blood flow reaches synovial folds of syntition capsules, meniscovs, cross-shaped ligaments.
The inner and outer lower, participating in the formation of the trophic of the fabrics of the arterial network.

The outflow of biological fluid enriched gas is carried out by carbon dioxide. The vessel is formed during the merger of segments that collect devoid oxygen blood from the compound structures.

Muscles, bones and knee bundles are combined into a complex that performs a number of complex interactions. When the first symptoms of damage to any of the considered formations of the compound should immediately apply to the doctor - the consequences of even minor injuries can lead to immobilization of the limb.

The articular bag (Bursa) is located in the extreme part of the cartilage and meniscus. It is the main element that protects the cartilage from serious mechanical damage and injury. Additional strengthening is carried out at the expense of muscles. Anatomy Bursa depends on its location. The entire joint mechanism is concluded in one capsule, which is based on cartilage, bones and ligaments. All this is hermetically hidden behind a special bag. It is attached to the bones and performs a lot of important functions.

What is the basis of knee joints

The articular bag is additionally strengthened by tendons, the knee cup is located next to it. It closes and protects the fitting from excessive pressure and negative impact from the external environment. From the side of the sides are internal and exterior ligaments, they act as additional strengthening elements.

In the cartilage cloth there is a lot of folds that provide flexibility. The inner sheath of the knee joint swears the articular surfaces of the bones, forming pockets. In medical practice, they are called coordinates and bursami. Hence the common disease bursitis originates.

The kole of the knee joint has a close relationship with synovial bags. A total of 13 main crops are recorded, which affect the flexibility and production of the necessary amount of articular fluid. These elements form a single cavity.

Bursa is represented by a small pocket, fully filled with liquid. The main function of the element is to reduce the load of the knee joint during the movement. Bursa absorbs blows and mechanical effects. It is in close proximity to the carter. Outside, the protective element is lined with a fibrous shell. It is characterized by increased density and durability. It is based on dense connective tissues.

The shell of the knee cartilage is responsible for the production of synovial fluid. It plays an important role in the workability of the joint. The shell is very sensitive to injuries and influences of various types.

Shoulder and elbow joints

Around the shoulder clinger is a few burs. Together they make up the sliding apparatus of muscular-tendon formations.

At the level of large and small tubercles, tendon passes. It is located in a special furrow. On all sides of the shoulder clinger, a dense overlap is recorded, without a blow to the main capsule.

Cellular compound are synovial bags. Some of them are located on top of the tendon, the other is under the acromic process. In some cases, dragging shoulder bags is fixed. The result of this process is to obtain a common fake-shaped bursa.

Migrate vascular and nervous beam with surrounded nerves is inside the formation. Its location is closely related to the main access to the cart. The status of the elbow connection directly depends on its protection.

Characteristics of ankle cartilage

Anatomy of ankle is not a special difficulty. The joint of the two main bones, Tibial and Malobersova. Additionally, the feet are attached to them. The lower distal bones for their location form a nest, which is based on the outflow of the foot. This connection is the main ankle cartilage. It contains several basic elements:

outdoor ankle;
inner ankle;
bone elements.

Outdoor ankle isolated two edges and surfaces. In the back there is a deepening to which the tendons of the Mulobert muscles are attached. Side bundles are pressed to the outer surface of the ankle joint. An important element is fascia, they are connective shells. Elements are formed using cases covering muscles, nerves and tendons.

The inner surface is the hyaline cartilage. It, together with the upper tranny bone, is an outer gap of an ankle joint. In the aggregate, all elements represent a solid construction, due to which the optimal protection of the roaster from the negative impacts from the environment is achieved.

Anatomy of the compound is thought out by nature to the smallest detail. Thanks to this, the joints are movable, elastic and bending.

Hip cartilage and its specificity

The features of the structure of the hip compound are to be in its nuts-shaped form and belonging to the belt of the lower limbs. The element combines the pelvic bone and cartilage by the articulation of the articular depression. The surfaces of the bones are covered with a special smooth layer.

The fibrous capsule is located, like the elbow connection. It is localized along the edge of the articular depression, her cartilage lip is in the connection cavity. The upper part of the capsule is attached to one quarter of the thigh length. Rear it does not reach her half.

Emnoting and intra-articular ligaments of the hip joint strengthen its strength. Deep layers of capsules are responsible for its content. This plot is called a round zone, it covers the neck of the hip and underlies the bursa of the hip joint.

The main feature of the hip joint is its deeper landing. The joint is distinguished by increased strength, but it has fewer freedom of action. Healthy cartilage provides movement in three planes. Extension and bending are carried out due to the front axle.

moisustav.ru.

Virasana

1st option correctly. Foot sock should be directed strictly back. This minimizes the shine shift to the outside of the hip. But, in any case, Virasan is intensively stretched by a lunch of the patella.

The 2nd option is incorrect. Turning towards the stop rotates the shin, pulling the medial-collateral (inner side) and the front crucible bundle, squeezes the lateral (external) meniscus.

aYC108.com.

Ethiology of the disease

The causes of the occurrence of the sprapatellular brusitis of the knee joint there are a large amount. The most frequent of these includes the following:

Mechanical injury in the region of the suprapatellular bag. Often, gymnasts, runners and other athletes are faced with such injuries. Injury may be different, they own bruises of soft tissues, microcracks, stretching, blows, falls. Therefore, professional athletes need to wear equipment. In addition, protect the knees must necessarily need equestrian personnel.
Regular vibration effect on the knee articulation, too heavy loads. With this, loaders, builders constantly face.
Bone tuberculosis.
Infectious pathologies also lead to the formation of suprapatellular bursitis.
Infection Bursa may occur due to an open wound, fracture or scratch.

Run the formation of inflammation is capable of deformation of the joints, which can be congenital or acquired. Autoimmune (systemic red lupus, rheumatism), allergic and endocrine diseases, chronic joint pathologies, violation of metabolism in the body also contribute to the development of the suprapatellular brusitis of the knee joint.

How does pathology manifest?

Suprattellular roar of the knee joint has various symptoms. Inflammation is located next to the thigh quadrup, under the browser. Pathology proceeds sharply or is chronic. With acute inflammation of the knee mucosa, the following signs:

hyperemia appears;
pain syndrome constantly accompanies the patient;

the swelling is first localized in the Bursa area, then goes to the knee cup, a popliteal area and a number of muscles and tendons;
edema can be of different quantities, its size depends on the power of the impact or the degree of flow of the disease;
to the touch leather around the knee joint and above it becomes hot;
the patient becomes hard to carry out movements in the knee joint;
the shape of the knee changes due to the occurrence of swelling, which can be 2 times more articulation.

The purulent bursitis of the inflamed near-handing bag is accompanied by difficult to accumulate synovitis, and purulent exudate. In connection with the formation of pus, active and passive movement in articulation is almost impossible, the temperature rises sharply, acute pain appears. The lack of treatment is fraught with terrible consequences, the affected may begin to develop abscess or phlegmon. In the chronic course of the disease, the synotes accumulates gradually. This form of the disease is characterized by periods of exacerbation and remission. Chronic Bursitis is characterized by the appearance of whitish formations on the inner surface of the mucous bag. As a result, whitish formations begin to separate, thus, a foreign body appears in the bag, which must be removed immediately.

Diagnostic measures taken to form a diagnosis

Suprattellular roars of the knee joint is diagnosed as well as all other diseases accompanied by inflammatory processes in a synovial bag. At first, the doctor studies the history of the victim, conducts a visual and physical examination of the knee joint. When examining, the doctor discovers characteristic signs of the disease: a tumor over a knee cup and soreness when performing exercises that are necessary to determine the amplitude of movements. Next, you need to carry out such instrumental methods of diagnosis:

Ultrasound of soft tissues;
the magnetic resonance or computed tomography of the knee joint is carried out if the disease recurred not the first time, or was caused by injury to the joint.

The formation of purulent exudate requires puncture, a synovial fluid is taken for bacteriological and cytological research. Exudate can be serous, fibrous, purulent, hemorrhagic. After the symptoms were clarified and the treatment is appointed, the patient is placed in the hospital until full recovery or ship to be treated home.

Conservative therapy of the pathological process

To treat the suprapatellular roar of the knee can be drugized, with the help of physiotherapy and folk remedies. To minimize swelling, it is necessary to wear an orthosis or knee pad, they stabilize the joints, reduce the pressure in the knees. While sleeping under the knee, it is necessary to put the pillow with a pillow, it will also help minimize the knee pain. For quick recovery, the joints need rest, so the knee often immobilize using the gulling bandage, Longhet or a gypsum bandage. With suprapatellular roar of the knee joint, treatment requires the use of medicines. To cure the inflammatory process, these drugs are used:

antibacterial drugs when breeching with purulent content;
steroid hormones, for example, "diprospan";
painkillers and antipyretic drugs (Diclofenac, Ibuprofen, Naproxen and others);
mioryelaxants help to remove muscle spasms, in this case they are necessary, therefore the disease can hit the thigh-round muscle due to its loved ones to the suprapatellular bursa.

What kind of drug you need can only say the attending physician, after examining the patient. In addition, you need to do exercises. The wellness program is calculated for each patient individually depending on the various indicators, which include the patient's age, the functioning of the knee joint. The program will consist of well-thought-out nutrition. Exercises reduce painful sensations and restore the functioning of the articulation.

Therapy of folk remedies: recipes

The best popular way to reduce swelling is the use of cold therapy. Place the ice directly on the affected area, this method will help reduce pain, reduce swelling. Ice on the knee must be kept for 20-30 minutes daily. As soon as you stop feeling the knee, feel numbness, try slow to bend your knee leg. Make a few exercises, just carefully. Exercises can prevent knee from deformation, and also provide blood circulation throughout the leg. Ice packages Apply 4-5 times a day.

Another good recipe: Mix honey with turmeric to get paste. Apply a paste on the knee in the form of a compression at the same time intervals, but at least three times a day. Honey has strong anti-inflammatory properties, and Kurkuma is a natural antibiotic, which prevents the development of secondary infections. Homeopathic preparations are also useful. Additives containing calcium and magnesium in the diet of the patient are considered very useful. These additives strengthen the bones, however, excessive use can lead to calcification in Bursa, which, in turn, can increase pain.

The use of chamomile oil on the affected areas is useful with suprapatellular bursite. Chamomile oil has an anti-inflammatory ingredient. Apply a few drops on the affected knee, the chamomile seeps into the skin tissue and helps to minimize the symptoms of the disease. It is also necessary to take turmeric, it is released in capsules.

sustavzhiv.ru.

Knee-joint

The knee joint (Articulatio Genus) is formed by the articular surface of the summers of the femoral and tibial bones. A patella (Patella), which is in the thicker of the tendon of the four-headed muscles of the thigh in the thickness of the tendon, arrives. The articular surfaces of the bones are uncongenant and complemented by two menisci.

The knee hood capsule is the most extensive among all joints and can accommodate up to 300 ml of fluid. On the femoral and tibial bones, the capsule is attached along the edges of the articular surfaces. To the patella, the synovial layer of the capsule is attached along the edges in such a way that the rear surface of it is addressed to the body cavity.

The synovial layer of the capsule has numerous folds and vile, especially well-pronounced around the patella and in the hole between the summers of the femoral bone. In the distal sections of the knee joint around its capsule there is a cluster of adipose tissue (Corpus Adiposum Infrapatellar), filling space, limited front Lig. Patellae, tibia and patella.

The cavity of the knee joint through cruciform ligaments (Ligg. Cruciata Genus) is divided into right and left parts (Fig. 146). Cross-shaped bundles of the joint and sides are covered with a synovial shell. In addition, the hollow of the joint is divided into the upper and lower departments with two cartilage menisci (Meniscus Medialis et Lateralis). The outer edges of both meniscus are thickened and fucked with a joint bag, and to the center of meniscus are thinned. In the middle of the meniscoves there are holes through which the upper and lower sections of the knee bundle are reported. The upper surface of the meniscoves is concave and repeats the curvature of the soils of the femoral bone, and the lower is flat and goes to the cartridge of the tibia math. The presence of meniscus deepens the articular surface of the tibia by 4-6 mm. The form of meniscus is different. Medial Menisk has a diameter more than the lateral meniscus. The volume of the knee joint increases due to the message of its cavity with synovial bags.

Sinovial Charging Bag (bursa suprapatellaris) the largest. It is located at 7-8 cm above the patella behind the tendon of the four-headed muscles of the thigh. In newborns, as a rule, it is isolated from the custody of the joint. In adults only in 20% of cases, the bag is separated from the custody of the joint with a thin jumper.

The bag of the popliteal muscle (bursa m. Poplitei) lies under the same muscle of the same name. In the field of lateral meniscus, the bag is reported to the cavity of the knee joint.

The bag of semi-sephel muscles (Bursa m. Semimembranosi) is located between the medial model and the semi-peculiar muscle. The bag is reported not only with the cavity of the joint, but also with a bag lying between the head of the calf and the webcate muscles.

Bag of the calf muscle (Bursa m. Gastrocnemii Medialis) is located between the head of the same muscle and the articular capsule.

The knee joint has even mucous bags that are not communicating with the cavity of the joint. These bags arose as a result of the pressure of the tendon or skin on the bone and soft fabrics (Bursa m. Gastrocnemii Lateralis, Bursa Anserina, Bursa Infrapatellaris Profunda, Bursa Prepatellaris Subcutanea).

Bundles. Bundles of the knee joint strengthen the joints capsule and are involved in the combination of bones (Fig. 147). Bags include oblique and arcuate patellied ligaments (Ligg. Popliteum Obliguum et Arcuatum) located on the rear surface of the joint capsule. Kosy bunch is a continuation of a part of the bundle of the tendon of a semi-sephel muscle, arcuate - thickened lower edge of the fibrous layer of the articular capsule. Bundles of the knee joint involved in the combination of bones are well developed.

The Maloberstar Collatomeral Bundle (Lig. Colladerale Fibulare) is a thick heavy, which begins from the lateral hammer of the hip and reaches the head of the Metoborian bone. Passing around the joint, separated from the joint capsule with a loose fiber.

The tibial collateral bunch (Lig. Colladerale Tibile) descends in the form of a wide heavy bone from the medial impact. Passing near the joint, growls with the outer edge of the lateral meniscus; It is attached on the side surface of the tibial bone. The tibial collateral bundle is significantly more developed than the previous one. This is due to the fact that when extending in the knee joint, the tension of the ligament increases due to the large radius of the lateral dish.

A bunch of the patella (Lig. Patellae) represents the continuation of the tendon of the four-headed muscles of the thigh. It is attached to the tibia jergis. From the side parts of this bundle, bundles are separated, which are woven in the joint capsule in the form of a tendral stretching (Retinaculum Patellae Mediale et Laterale). These bundles strengthen the sidelines of the joint capsule.

Cross-shaped front and rear ligaments (Ligg. Cruciata Anterius et Posterius) - very durable education. The first passes from the inner surface of the hip lateral mystery to Area Intercondylaris Anterior Tibiae. The bundle is stretched when flexing in the knee joint. The rear bundle begins on the inner surface of the medial model, then goes back and down, attaching to the Area Intercondyloidea Posterior Tibial Bone. The rear bundle is developed somewhat better than the front. Together in Lig. Colladerale Tibile, when the femoral and tibia bones are in a vertical position, it prevents the extension in the knee joint. Thus, the rear crucible bunch, taking the load at the same time as collateral tibial, inhibits the extension in the knee joint, ensuring greater strength and stability of the lower limb.

Cross-bunch of the knee (Lig. Transversum Genus) is thin and short. Connects the front parts of meniscos, preventing their discrepancy.

The knee joint has a front axis of motion, where collateral and cross-shaped ligaments are performed by the function of the guide roller. The total mobility of the shin in the knee joint is 170 °, where 130 ° is active bending, 30 ° is passive bending and 10 ° comes to re-install. Processing and final rotation * The thighs in the volume of 5 ° are performed only with rapid walking and performing very sharp and strong movements. In the bent joint, when Ligg. Colladeralia Tibile et fibulare and lig. Cruciatum Posterius is relaxed, it is possible to move around the vertical axis with a total volume of about 40 °. Flexing and especially extension in the knee joint are performed smoothly not only due to the muscular tone of flexors and extensors, but also by virtue of the special location and shape of the femoral bone mysteries. With a bent of the knee joint, the radius of the hips in the rear section is 1.5-1.7 cm. This radius increases the kleon to 3.8-4.1 cm. Thus, the radius of the sumpers will increase during the extension (Fig. 148). Therefore, as the ligaments voltage increases, which is a factor inhibiting movement. Menisky, consisting of elastic cartilage, and fat cushions provide with each position of the mysteries that the congruence lacking for them.

* (When final rotation is performed on the medial satellite of the hip, a turn inside by 5 °. As a result, the turning of the lateral summers comes into contact more tightly with the articular surface of the tibia.)

The value of the trapped cup in the movements of the knee joint is that it facilitates the sliding of the tendon of the four-headed muscle of the thigh on the lower epiphysis of the femoral bone on the area 5-7 cm. In addition, with a reduction in the four-headed thigh muscle, the lower end of the patella rises up and forward, increasing the angle of the approach Lig. Patellae to the tibia. This is more profitable to increase the moment of rotation of the muscle strength.

Radiographs of the knee joint

On the X-ray picture in the days of projections during the disintegrated knee joint, the knee and greynebertz-small-terber joints are visible. The shadow of the patella layered on the shadow of the femoral bone. On the side picture, the patella is ahead of the disintegration of the hip.

The axis of the thigh diaphysis with the axis of the sumpers is forms an angle of 80 °. Visible elevations in places attaching ligaments and muscles. The finely visible structure of the spongy substance of the femorals and the epiphyse of the tibia is clearly visible.

vmede.org.

Anatomy of the knee

The basis of the structure of the knee joint is the articulation of the two main bones - the femoral and tibial. Thickened endings of bones are called sams. The mysteries are covered with a smooth guial cartilage, facilitating the gliding bones in the joint. The third bone of the knee joint is a patella (the knee chashchka), located in the thicker of the tendon of the femoral muscle.

Bone elements are surrounded by a cartilaginous plate. This is an education whose thickness is 5-6 mm. The structure of cartilage smooth and elastic, which achieves ideal conditions for ensuring the functionality of the joint.

All bone joints are fastened with bundles. There are many of them, they are located both in the articular cavity and beyond. Main bundles of the knee joint:

collateral (larger and small);
passed (arcuate and oblique);
medial;
lateral;
bunch of the patella;
cross-shaped (front and rear).

Bundles combine the elements of the joint into a single whole, simultaneously making the joint not with a monolith, but by moving articulation.

Articular capsule (bag)

Outside, the joint is surrounded by a connective tissue capsule having 2 shells: outer (fibrous) and internal (synovial). The inner sheath forms folds and coordinates (bursa) in several places of the articular cavity. In Bursah, the articular fluid is produced, providing lubrication and power to cartilage.

The anatomy of the bag of the knee joint is complex, but thanks to her, a person has the opportunity to walk, jump and sit down.

Menisky

The structure of the knee joint of the person includes menisci - cartilage, which provide a uniform distribution of body weight. The location of meniscus - between the ends of the femoral and the tibial bones.

Menisk fabric is more elastic than the cloth of hyaline cartilage. In fact, meniscus is a kind of gasket that ensures the full performance of the knee functions.

Important! The anatomy of the knee joint is that all its elements are in close cooperation with each other, and it is worth something to fail as dysfunction applies to the entire joint.

Muscular corset

Movement in the knee joint is impossible without muscle. The knee muscles provide the main function of the leg - walking. All muscles adjacent to the knee are divided into 4 groups.

A group that ensures the bending of the tibia: double-headed, semi-recreak and semi-dry muscles of the thigh; tailoring; ionic; traded; Thin.
Muscle-extensor group: Four thigh muscle; Straight, intermediate, lateral and medial thigh muscles.
A group that performs the pronation (rotation of the thigh knutut): a popling muscle; tailoring; Thin.
A group that provides a hip suspension (dust rotation): Blood Muscle Hip; Partially icy muscle.

The agreed activity of all these muscles becomes possible thanks to the innervation of the knee joint.

Cell supply and fabrics by nerve fibers

Innervation of the knee joint, that is, providing all its cells and tissues by nerve fibers, is carried out with the participation of the following nerves:

Sedal, poning, tibial and small -board perform the function of maintaining the sensitivity of the knee joint.
Plonde nerve is divided into a small-terberry and tibial.
The Tibial nerve passes along the back of the knee and is attached using the branches of the knee joint.
Maloberstska nerve is located on the front of the knee cup.
Nervous fibers of meniscus intertwined with blood vessels of the knee. Pass through all the cartilage body.

Despite the fact that the nerve fibers in the knee joint are not distinguished by too developed structure, they are of great importance for the proper operation of the lower limb.

Important! The structure of the knee joint is such that it is worth the failure of at least one nervous end, due to its deformation, the development of sclerosis begins.

Blood supply of the knee joint

In the knee joint, the vessels form a complex plexus, binding among themselves anastomoses. Thanks to the arteries (knee and patellite), oxygen flow and nutrients in all knee cells are ensured.

The vein network passes from the articular bag, permeating the olive fiber.

All major blood vessels are located on the rear surface of the knee joint.

About the knee joints say that they are the strongest and enduring in the human body, but are the venue of frequent appearances of inflammatory foci and mechanical damage. The most common knee injuries are associated with the gap of the meniscus and damage to the ligaments.

This is the name of the place of attachment to the tibial bone of tailor, semi-dry and fine muscles. The tendons of these muscles form a triangular tendon stretching, which is similar to a goose paw. Under them is a synovial bag, the necessary and vulnerable component of this joint.

In the knee joint there are several articular bags lying along the tendons and muscles. They are small pockets filled with synovial fluid. Sinovial bags are communicated with the intra-articular cavity and are needed to reduce friction and mechanical load on the joint, and during injury they quit a blow.

Doctor Karalin tells about the "goose foot" syndrome.

The knee consists of three bones, muscles providing its movement, nerve endings and blood vessels, meniscus, cross-shaped ligaments. Such a complex structure is due to high loads. The anatomy of the knee joint provides maximum convenience when moving on 2 limbs. Primates the structure is much easier due to the presence of 4 limbs.

The surface of the femoral bone (summers) has the form of ellipsoids. Medial mumane has greater curvature than lateral. There is a pea surface between the mysteries. It is located in the front of the femoral bone and is separated by a vertical groove on a smaller internal and greater external sect. They are connected to the rear articular surfaces of the patella.

The surfaces of the micales are slightly concave and do not correspond to the bends and curvature of the femoral bone. Despite this discrepancy, the intermediate cartilage (internal and external meniscus) align it.

The knee joint capsule forms several synovial bags. They can be in various places of muscles and tendons, clutching inside and between them. Sinovial bags can be among the bones and ligaments.

The tendon of the 4th head of the thigh muscle and the front surface of the patella form a docking pre-train bag among themselves.

These are the largest synovial bags of the knee joint.

For the normal operation of the knee joint, there are a number of muscles that can be divided by their location:

The front surface of the hip is a four-on muscle.
The back surface of the hip is a double-headed muscle, semi-dry, semi-proof.
The inner surface of the hip is large, thin, long, short, leading muscles, creamy muscle.

There is a place on the shin where 3 thigh muscles are attached - tailoring, semi-dry and thin. In this place, a goose paw is formed, where the synovial bag is located.

Burst of the knee joint is an inflammatory process that affects the synovial knee bag.

Bursa is a small pocket in which there is a small amount of fluid.

Sinovial bags are located at the scene of the junction of the tendon and muscles, so they are responsible for reducing the load on the joint.

Near the knee joints there are 3 synovial bags and each may be inflamed, and this can be both bursitis and synotes

Suprattellular (infrapatellular) bursitis of the knee joint - this species is also called a drop-down bursitis, since it develops in a popliteal synovial bag. The reasons for the development of this species - injuries of tendons in the area under the knee.

Baker's cysts - the Beginning of the Baker's cyst can indicate both the synovit, and on the bursitis due to the similarity of the symptoms. However, this type of brusitis develops on the inner side of the knee and quite often the disease is striking people with obesity.

Preparetory bursitis - the brusitis of the knee joint of this species is most often found. Development occurs in a synovial trapped bag, and the causes in various injuries and damage to the knee cup.

Despite the fact that synovitis and bursitis is similar in the initial phase of its development, the reasons for Bursita are based on:

Frequent kneading injuries,
high loads on the knee joint
infectious diseases that are affected by Bursa
small bruises, injuries and abrasions near the synovial bag.

Separately, it is worth saying about the development of the so-called bursitis of the goose paw. Here the inflammatory process is striking not the entire articular bag of the knee joint, but only a separate area.

Most often, bouring bags of the goose paw develops in older people, since it is a complication of the deforming osteoarthrosis of the knee joint.

Much more rarely bursitis goose paws can be diagnosed in young people.

In medical practice, the bursitis of the goose paws is rarely used, synonym is an anzherine bursitis, that's the disease is indicated.

In addition, Anzherin Bursit is unwinding on the background:

diabetes
gap meniscus
arthritis of the knee.
flatfoot
obesity.

Symptoms

The symptoms of the brusitis of the knee joint depend on the phase in which inflammation is. To the main manifestation, we will take the following:

The manifestation of pain, and if it is acute roars of the knee joint, then the pain sharp, sharp and pronounced.

Both synovit and bursitis the knee causes a slight stiffness in the area of \u200b\u200bthe inflamed joint.
above the inflamed joints are clearly visible redness and swelling, as in the photo.
there is weakness in the muscles,
the patient complains about malaise and reduction of working capacity,
local temperature increases are recorded.

Before treating the roar of the knee joint, it is necessary to exclude specific infections that may cause inflammation.

These infections are most often related to:

Brucella
Gonococci
Spirochetes.

Naturally, both synovit and bursitis must be distinguished from arthritis, it is based on analyzes.

As for directly treatment, then, for example, with acute bursite at an early stage, the patient must be alone. For the knee, a gulling bandage and warming compresses are used.

In addition, the disease is treated with anesthetic and non-steroidal anti-inflammatory drugs.

If there is a purulent inflammation with the discharge, it will be necessary to undergo a course of antibiotics, and antibiotics are introduced directly into the knee joint, these are intra-articular injections and the knee joint.

The disease involves the use of local therapy to reduce pain. Both synotes, and bursitis can be treated at initial stages with ointments and creams with a warming, anti-inflammatory and painkillery effect.

The restriction of mobility in the joint requires the use of a complex of physical education. These are special exercises that are developed individually.

The fulfillment of the treatment of therapeutic physical education leads to the restoration of the basic functions of the knee. LFCs are used in this case, as an additional treatment of brusitis of the knee joint.

Physiotherapy procedures are also appointed. As the knee joint is restored, it is recommended to increase loads, and for this you will need to start playing sports and best of all swimming.

As for the invasive methods of treatment, the development of chronic bursitis can be said. This development will require the use of a puncture to remove the accumulated fluid.

After the drainage of the exudate is carried out, it is necessary to wash the bag cavity with a special solution of antibiotics and antiseptics, it should prevent complications and the development of purulent inflammation as in the photo.

The prediction in the treatment of bursitis always depends on several factors, it is:

the degree of change in the tissues of the knee joint
prevalence of the inflammatory process
the ability of the inflammatory process to further develop and capture new fabrics and sections of the joints,
resistance to the patient's body inflammatory process.

In the treatment of Bursita in some cases, unconventional methods can be used. However, it is necessary to immediately clarify that traditional medicine should act as an additional funds in a complex with medication, but not the main one.

Frequently used compress from vegetables, and vegetables can be alternating, it can be potatoes, cabbage, beet.

For example, we take potatoes, it is cut in front of thin layers, placed on clean material and the inflamed joint is rocked.

A film and wool handkerchief is superimposed on top to the joint, such a compress should be on the knee joint all night. Such treatment allows you to take part of inflammation and reduce pain.

Near the next night, you can use the compress from crude beets by the same principle, then the compress made of sliced, fresh cabbage. Treatment continues until inflammation has been removed

Another interesting recipe involves the use of compress with sugar. For this it will be necessary:

on a dry pan heat sugar, but so that it does not start melting,
then hot sugar is shocking in a small bag of tight fabric,
the bag with sugar is applied to the affected joint all night,
top is covered with cellophane and wedged with a warm scarf.

The procedure can be repeated to complete recovery, that is, before the removal of inflammation

In the treatment of bursita helps to cope with Celery tea. This drink leads to the strengthening of the body as a whole, and negatively affect any inflammatory processes.

For cooking, 1 tablespoon seed celery and a glass of boiling water is needed. Tea is insteaded for 2 hours, after which you can take it twice day for 14 days.

The knee has a complex structure, it forms three bones. The joint is able to withstand heavy loads, it provides the following movements of the foot:

flexion;
traffic;
extension;
rotation.

Functions and traffic

The knee joint can perform the following movements: flexion, extension and rotation. The character of the joint is sochy. When extensing the meniscus, they are compressed when flexing. Due to the fact that collateral bundles are relaxed in this position, and their attachments are as close as possible to each other, the possibility of movement - rotation appears.

When the tibia is rotated inside, the movement is limited to cross-shaped ligaments, when moving outwards, they relax, and the amplitude is limited to the side.

Genuine of the meniscus of the knee joint: causes of injury, symptoms, diagnosis and treatment methods

The anatomy of the knee joint for many years studying the structure and functions of meniscus, since injuries associated with them are very frequent phenomenon.

Menisky is three-edged cartilaginous plates thickened outside (struck with the articular capsule), inside the joint and pointed and pointed. They are concave on top, it is flattened from below. From the outer edges, they repeat the anatomy of the upper edges of the Tibra Tibony.

The lateral meniscus in shape is similar to a part of the circumference, and the medial resembles a semi-short form.

Fastening the cartilaginous plates occurs in front (with the help of a cross-ligament of the knee) and behind the tibia (interlimated elevation).

Among the traumatic pathologies of the articular apparatus of knee injury occupy a special place in frequency, complexity and significance of the consequences, due to its difficult structure and fewer soft tissues that protect the bone part of the joint. The most frequent diagnosis becomes a break of the meniscus of the knee joint.

The injury is widespread among athletes, occurs with uncontrolled loads on the legs associated pathologies, in age patients with developing arthrosis.

Menisk is a small cartilage, outwardly similar to crescent, with a fibrous structure, is in space between the joint surfaces of the femoral and tibial bones. From the functions, the most important is the amortization of movements, meniscus also reduces the articular friction and ensures complete contact of the joint surfaces.

In the knee joint there are two meniscus:

external, also called lateral;
internal, also called media.

The lateral meniscus, the more mobile and dense structure, is injured to a lesser extent, the medial is attached to the bone to the bone and the joint capsule, and are more susceptible to damage.

The anatomy of meniscus includes the body, turning into two horns. The edge, or the Red region, is the most dense part of the organ, with a thick network of blood vessels, and after damage is restored faster than the central white region - a thin part, deprived of capillaries.

Depending on the injury force and the point of application of its impact, damage may be as follows:

The rear horn of the medial meniscus may be inner, transverse or longitudinal, patchy, fragmented. The front rog happens less frequently. According to the degree of complexity, the gap can be complete and partial.
The separation at the point of attachment to the joint, in the body area in the near-therapist region, and the horizontal tightness of the rear horns. It is considered the most serious injury of a meniscus cartilage, which requires surgery of surgeons, in order to avoid pinching the meniscus, blocking the joint and the destruction of a number of cartilage.
The pinching of the meniscus - this occurs in almost 40% of cases of breaking or the separation of cartilage, when a part of the meniscus is blocked in movements.
Combined injuries.
Chronic cartilage degeneration, permanent trauma and rebirth in the cyst.
Pathological mobility due to injury to menisk ligaments or degenerative processes of its tissue structures.

Provocative factors:

Verification on one leg without breaking away from the surface.
Intensive running, jumping on an unsuitable for this surface.
Long-term squatting, intensive walking of the Housing.
Congenital or acquired weakness of the articular apparatus of the knee.
The degeneration of cartilage, when even a small injury can cause a break.

Menisk injury to diagnose immediately enough, it happens, as a rule, together with the general damage to the joint, and at the initial stage of the development of traumatic inflammation, signs of damage to the meniscus are indistinguishable from the clinic of injury of other components of the joint.

Clinical manifestations of injured joint:

Acute pain in the first minutes after injury, sometimes accompanied by a clock sound.
Knee swelling.
Small gaps are manifested by clicking and movement problems.
A large rupture completely blocks the joints of the joint.

General manifestations disappear or decreased after two to three weeks, and the symptoms of meniscus are described:

soreness of the roller in the articular gap region;
local pain;
infiltration of the joint capsule, may be hemarthrosis, if the red zone of cartilage is torn;
exudative effusion;
specific click in the process of bending the knee joint;
the joint becomes completely blocked;
skin temperature in the injured joint;
the chronization of the process can cause foot muscle atrophy.

If the injury is chronic, the severity of symptoms falls, and it is possible to suspect damage by such signs as:

Pain in the knee when walking on the stairs.
The soreness of the articular gap, especially when pressed.
Inflammation of the articular bag.
Amyotrophy.

Inflammation during the break has an acute and shadow phase:

The acute phase is characterized by the presence of a non-specific reactive inflammatory process, with local painful phenomena in the articular slot. The patient almost does not exist to the leg.
Subacon phase - a period of poeing acute symptoms. There may be: localized pain, fluid effusion in the articular cavity and blockade of movements.

The symptoms of the gap of internal and external meniscoves has some differences. The gap of medial meniscus is characterized by:

Pronounced painful manifestations on the inner part of the knee.
Spacious pain in the palpation point of fastening the ligament to the meniscus.
Surability when flexing the legs and the propulsion blockade of the joint.
Painful exterior shin turn.

Signs of damage to the lateral meniscus:

pain in the external knee department;
painful inner tangle turn;
the weak muscles of the front area of \u200b\u200bthe thigh.

Diagnosis of injury

The diagnostics of the removal of meniscus is hardware and symptomatic. By inspection, aspects and tests, you can diagnose with high accuracy, however, additional surveys are appointed for complete confidence.

In the process of diagnosis, the patient passes the following tests:

The symptom of the stunt: The patient flexs his leg at right angle. Further rotation of the knee causes painful phenomena.
Landa's symptom: the patient because of pain in the joint can not sit in the lotus position.
Symptom of Baikov: The patient bends his leg at right angles. The doctor puts pressure on the area of \u200b\u200bthe articular gap. The patient extensions the leg, the pain appears in the knee.
Symptom of Perelman: the patient is difficult to descend the stairs due to the pain in the knee.
The symptom of the turner: the sensitivity disturbance of the knee.
Symptom Mac-Marreya: The patient bends his leg at right angles. Further rotation of the leg inside or outward causes pain. This determines the gap of the medial meniscus or lateral.

Polyakova's symptom: The patient is placed on the back, raises the body and healthy leg, relies on the heel of the injured leg and their blades. Menisk damage will reflect pain.
The symptom of the chaklin: characterized by a strained or flattened tailoring muscle of the thigh in the process of extension of the lower leg.

Hardware diagnostics includes radiography, computer and magnetoresonance tomography, arthroscopy. The most accessible and frequently used method is x-ray. In difficult cases, if necessary, to visualize the problems of near-state formations use MRI. Arthroscopy, except for diagnostics, is also used in the operational treatment method.

The rupture of the meniscus of the knee joint is an indication for immediate treatment, otherwise there is a risk of developing a chronic process. The consequences of the solar discontinuity become meniscopathy and gonarthro-degradation of articular cartilage.

Treatment is conservative and surgical. Conservative treatment of acute injury of meniscus is usually effective when complying with all its stages and recommendations. In emergency cases and the absence of the results of conservative therapy, it is necessary to make a surgical operation.

Conservative

In minutes after injury, regardless of the degree of severity, the patient needs first aid, in the future its timely provision can facilitate the treatment process:

the patient's foot is stacked above the level of its breast - this allows you to prevent the swelling or reduce the degree of edema;
the damaged leg must be in full peace;
it is necessary to put a cold compress and keep the area of \u200b\u200bthe injured joint with an elastic bandage;

When pinching and blockade, the doctor conducts a refueling, manual technique or with a hardware traction, and solves the question of the imposition of gypsum.

Further conservative treatment includes taking non-steroidal anti-inflammatory funds: ibuprofen, diclofenac, indomethacin, nimesulide, etc. They remove pain, reduce the degree of inflammation and remove the swelling. After treatment, within the framework of rehabilitation, a course of physiotherapy procedures, manual massage and exercise exercise is appointed.

Chondroprotectors are prescribed to the patient - substances that restore cartilage fabric: chondroitin sulfate, hyaluronic acid for joints and glucosamine. Therapy with chondroprotectors should be conducted every year, 3-6 months.

How to treat a gap of meniscus - solved exclusively by the doctor!

Surgical

Indications for the operation include:

gap of meniscus with displacement;
crushing or scarmers of cartilage tissue;
full gap of meniscus and both horns;
blood in the articular capsule (hemartrosis);
low or missing effect from medication therapy for 2-3 weeks.

Surgical operation adheres to the maximum preservation of the integrity of the meniscus, if possible, and restore its functions.

Methods used:

Meniskectomy: Removing a tearsal meniscus or most of it is also carried out in the degeneration of cartilage, which joined complications. A little efficient operation, with further negative consequences for the joint.
Incomplete removal of meniscus: the parted part is removed and the edges are cut to the required state.
Menisk Transfer: Donor or Artificial Menisk is used. The manipulation is carried out when the tissues are developed and the predictable significant worsening of the quality of life. It is impossible to carry out people in older age, general-combat pathologies, articular diseases of a degenerative nature. There is a risk of poor implant survival, so the operation is unpopular.

Restoring Meniska: Stick damaged parts for a fight. For this operation there are indications if: meniscus is broken into the periphery; The gap is longitudinal and vertical; Menisk is cut off from the capsule; no degeneration in cartilage; Gap "Fresh" with localization in a red or intermediate region; Young age.
Arthroscopy of the knee joint: the least traumatic method used at present. The knee in two specific places pierce 1 cm. In one of the punctures, arthroscope and saline is introduced into one of the punctors, in the other puncture, the necessary internal manipulations in the joint are carried out.
Fastening Meniska: The broken parts are fastened with absorbent locks, without additional cuts.

Main ligaments

The brief anatomy of the knee joint always describes cruciform ligaments (front and rear), which are located directly in the knee. They are called intra -expasal ligaments.

In addition to them, in the joint there are side collateral (medial and lateral). They are also called extracassed ligaments, as they are outside the articular capsule.

Executive ligaments are represented by tibial and mulberry collateral ligaments. They begin with medial and lateral thigh-bone supermarkets and are attached to the top epiphysis of the tibial and the outer surface of the mulberry bone, respectively. Both are connected to the joints capsule.

Intra-capsule bundles, front and rear cross-shaped on the inner surface of the lateral and medial satellite of the thigh, go ahead and inside (down and inside), are attached to the front and rear field of the tibia, respectively.

The topographic anatomy of the knee joint, in addition to intra-articular and embracing, studies other ligaments.

The bundle of the patella is called the tendon of the 4th head of the thigh muscle, which comes from top to bottom, comes to the patella, wures it on all sides and continues down to the tibia. Side tendon bundles go on the sides and are directed from the patella to the medial and lateral soaps of the tibia. They form outer and internal supporting ligaments of the patella.

In supporting bundles of the patella there are horizontal beams that are attached to the thigh supersts. The function of supporting bundles is the retainer hold in the desired position.

Behind the articular capsule is strengthened by a slanting ligament. It begins on the Matter of the Tibia and is attached to the sacrifice of the femoral bone, giving part of the beams to the articular capsule. The bundle takes part of the beams from the tendon of the muscles of the thigh, namely from the half-dress muscle.

The transverse bunch of the knee connects the meniscus along their front surface.

Anterior meniscriced bundle originates from the forefront of the internal meniscus, follows and the dodder, to the lateral satellum of the thigh.

The rear menescript bundle originates from the rear edge of the external meniscus, follows and inside, to the medial disinth of the thigh.

The mysterious knee joint works as a block-shaped, being in a dispere position. The anatomy of the knee joint allows you to rotate the vertical axis in the bent position.

The inflammatory process in the articular bag of the knee occurs quite rarely due to the anatomical features of the structure. Characteristic symptoms of bursitis are similar to other diseases of the knee joint, so after the appearance of the first signs of pathology, you need to contact a specialist.

Symptoms of Anzherin Bursitis:

Constant stupid pains from the inside of the knee due to the accumulation of synovial fluid;
Unpleasant sensations at the palpation of the joint;
Restrictions in the movements of the joint;
In physical exertion, seizures in the legs are possible;
In the knee, swelling, swelling and redness may occur;
Patients may complain about discomfort and feeling of the presence of a foreign object in the joint area.

Periatritis ─ This is the inflammation of the occasional apparatus in which the joint itself is not involved. It is most often happening on the inner side of the knee, which is attached to the tendon of tailor, semi-dry and fine muscles, since this area is experiencing the greatest load.

The inflammatory process in the knee joint is developing in response to damage that can be different in nature:

According to the international classification of the diseases of the 10th revision, periatritis refers to diseases of soft tissues and can have code from M60 to M79, depending on the type and cause.

Capsule Sustav

The articular capsule is attached to all three bones involved in the formation of the joint.

To the thigh bone, the fastening occurs under the screws, to the tibial - along the articular surface, to the patella - along its articular surface.

The most developed folds are wonderful. They go on the sides of the patella up. And contain a sublovers of the fat body between their sheets.

To the thigh bone, the fastening occurs under the screws, to the tibial - along the articular surface, to the patella - along its articular surface.

Grass Knee Sustava

Knee injury - very frequent phenomenon. In order to diagnose the cause of the joint pain, the doctor very often appoints MRI. The anatomy of the knee joint (bone, ligaments, muscles, artery, etc.) is visible in the picture, which will determine what cause is unpleasant sensations.

Symptoms

In order to deal with the reasons for the development of bursitis of the goose paw, you need to consider this part of the knee joint. The bag of goose foot lies within the medial surface of the lower leg. This area is surrounded by a tailoring, semi-dry and thin muscle, the goose paw is located precisely in the field of attachment of these muscles to a large beritic bone.

Despite the fact that in most cases the bursitis of the goose paw develops against the background of the progressive deforming osteoarthrosis, there are still many other factors that can lead to the development of this pathology.

The most common belongs:

obesity;
gap of meniscus;
professional jogging;
flatfoot;
incorrect weight distribution when walking;
diabetes;
strong stopping of the foot;
arthritis of the knee.

The anzherine burse of the knee joint is quite rare, and even less often than bursitis the hip joint. It's all about the location of this part of the articular bag, because in this area of \u200b\u200bthe fabric, the bags are subjected to friction not so intense as in other parts of the knee joint.

As a rule, the brusitis of the knee joint develops with the defeat of the bursa located under a cup or in the popliteal area, while in the field of goose paws, the articular bag is less susceptible to injuries that most often become the cause of other types of this disease.

Damage to the articular bag is always accompanied by inflammation of its fabrics, but in the case of a bag of goose paws, everything is somewhat more complicated, since the course of the disease of this area is often complicated by the tendinite, that is, the inflammation of the muscle tendons, which are attached to the big berth bone.

The symptoms of the lesion of the articular bag are not always quite unequivocal in order to determine exactly which disease they cause them. The most characteristic symptoms of this disease include:

pain on the inside of the knee;
strengthening painful sensations when driving a joint;
strengthening pain with significant physical exertion.

It should be immediately noted that such symptomatic manifestations are not rare and with other no less dangerous diseases of the joints. Given that the roar of the knee joint is accompanied by an inflammatory process, a small increase in body temperature may occur in patients.

Like any other type of inflammation of the near-handing bag, the disease is treated with anti-inflammatory non-steroidal drugs. The drug reception scheme appoints a doctor, depending on the intensity of the manifestation of symptoms. In addition, glucocorticosteroids can be assigned to introduce inside the synovial bag.

At the time of treatment, it is necessary to ensure peace for the sore joint, minimize all physical exertion on it.

Passive physiotherapy has a beneficial effect, including ultrasound with hydrocortisone. In order for the treatment to be as effective as possible, the load should be lowered to the injured knee during the period of active tissue restoration. After all the symptoms appear, you can gradually enter the load, doing therapeutic physical education.

Bursa is surrounded by muscles and tendons, in good condition they do not bring discomfort. But there are factors that provoke the development of bursitis goose paws:

Exhausting loads on the knee joint;
Long-term kneeling;
Excess weight;
Injuries of joints, fall and bruises;
Diabetes;
Foot pathology;
Genetic predisposition;
Arthritis and tendinities lead to irreversible changes in articulation.

To eliminate the anzherine bursitis of the knee joint, a set of measures is required, which includes the reception of medicines and physiothereders. First you need to ensure peace of sick leg, immobilizing the joint.

It is possible to remove the first symptoms at home, for this Ice compress is suitable for this. It is applied to the knee for 20 minutes a couple of times a day. Further course of treatment of Bursitis of the goose paw of the knee joint must appoint a doctor.

For the treatment of Anzherin Bursita, it is necessary to establish the nature of the appearance of the disease. With infectious damage, antibiotics are prescribed, which will help get rid of the causative agent, which caused inflammation. During therapy, reduce the burden on the joint. When taking antibiotics, it is recommended to in parallel to use prebiotics and probiotics in order to prevent the advent of unwanted reactions from the digestive system.

Effectively eliminate with pain syndrome Non-Steroid anti-inflammatory funds. They are prescribed by the doctor, depending on the individual characteristics of the patient. Usually discharge diclofenac, aspirin, nimesulide and others. If the NSAVS does not work, then the doctor recommends the reception of corticosteroids.

Preparations for local application are used to eliminate edema and pain, circulatory stimulation. Gel Doluben, Woltaren, Naz and Lolgitis perfectly copble with this task when performing the recommendations of the doctor.

To speed up recovery, the following physiotherapy procedures can be appointed:

Electrophoresis;
Magnetotherapy;
Treatment with infrared radiation.

The medical gymnastics appoints a specialist, very good for recovery after the bursita helps swimming.

If the disease has passed into the chronic stage, the operational treatment is assigned. During surgical manipulations, the excess liquid is pumped out of the articular bag, and then the operated area is treated with drugs that prevent the appearance of complications - suppuration.

Folk Methods

There are home recipes that help relieve pain and return the mobility of the joint. But they should be used together with conservative therapy to cure a pathological condition.

Description

The goose foot is conditionally divided into two types: deep and superficial. Deep form tendons of three muscles - fine, tailoring and semi-drying in the zone of attachment to the tibia.

The surface goose paw is called the plate of the triangular form of collagen fibers, which is located in several centimeters from the slot of the knee joint.

Such a fusion of tendons performs a supporting function and protects from movements that may adversely affect the mobility of the limb.

In the same area, Bursa is localized, which protects and maintains the normal operation of tendons.

In this area, uncomfortable sensations may sometimes appear. And the diagnosis of goose foot syndrome is set with the following symptoms:

detection of roller during palpation (it prevents sliding);
limitations when trying to flexing and extending the knee;
problems with performing actions with load and without.

After careful diagnosis, pathology is determined by specialists and the necessary treatment is selected.

Bursitis

Goose or Anzherin Bursitis is the inflammation of the knee section, which is mainly detected in older patients. Such a disease may be progressing against the background of the nestness of osteoarthrosis, the state of the problems with the regeneration of bone tissue is complicated.

The swelling can be unlikely to be a deep arrangement of bags, for example, under his own bunch of the patella.
The volume of movements is generally preserved, but local limitation of movements and pain is possible.
The skin over the inflamed bag is blushing, minor hyperemia can be observed.
With purulent bursitis, symptoms of elevated temperature, weaknesses and headaches are possible.

In the first days of exacerbation - ice on a sore place and peace.
With aseptic bursite - anesthesia with NSAIDs:
- ibuprofen, indomethacin, diclofenac, ketoprofen, naproxen, arthrites, etc.
With septic form - puncture with drainage and antibiotics:
- cephalosporin, Aminopenicillin, Carbapenem.
When infected with the prepareboard bag in its cavity, the half tube is inserted, which is usually enough to cure.
If the bag is so thickened so that there is no sliding joint, and severe pain arise, radical bursecetomy is carried out.
After the operation, the knee a week is fixed with orthosis.
Rehabilitation is carried out with the help of LFC and physiotherapy:
- laser therapy, ultrasound, electrophoresis, needleflexotherapy, contactless moxotherapy.

Increased load on the knee joint. They can serve intensive sports or excess body weight.
Ears and other traumatic impacts. They lead to hemorrhages in the intra-articular capsule, stretching and microcers, which are a good substrate for inflammation.
Arthritis and arthrosis of the knee joint ─ inflammatory and degenerative-dystrophic processes, originally localized in the joint area, in the future ─ exiting its limits.
The presence of an infectious agent causing inflammation. The causative agent of infection, occasionally occasionally in the near-blood area with a blood flow, becomes the cause of periatritis.

Therapy of folk remedies: recipes

The best popular way to reduce swelling is the use of cold therapy. Place the ice directly on the affected area, this method will help reduce pain, reduce swelling.