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The proximal tibial attachment of the sMCL is the primary stabilizer to valgus force on the knee, whereas the distal tibial attachment is the primary stabilizer of external rotation at 30° of knee flexion. [3] [9] The dMCL is a thickening of the medial aspect of the capsule surrounding the knee.
Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, [1] especially in the femur and tibial bones, but can also occur genetically at birth.
In the third and most common mechanism, the dashboard injury mechanism, the knee experiences impact in a posterior direction during knee flexion toward the space above the tibia. [ 10 ] [ 15 ] These mechanisms occur in excessive external tibial rotation and during falls that induce a combination of extension and adduction of the tibia, which is ...
Iliotibial band syndrome (ITBS) is the second most common knee injury, and is caused by inflammation located on the lateral aspect of the knee due to friction between the iliotibial band and the lateral epicondyle of the femur. [2] Pain is felt most commonly on the lateral aspect of the knee and is most intensive at 30 degrees of knee flexion. [2]
The greatest displacement of the meniscus is caused by external rotation, while internal rotation relaxes it. [1] During rotational movements of the tibia (with the knee flexed 90 degrees), the medial meniscus remains relatively fixed while the lateral part of the lateral meniscus is displaced across the tibial condyle below. [2]
The test is performed by slowly extending the knee from 90 degrees, maintaining internal rotation. Pain at 30 degrees of flexion and relief with tibial external rotation is indicative of OCD. [33] Physical examination of a patient with ankle OCD often returns symptoms of joint effusion, crepitus, and diffuse or localized tenderness.