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Knee Techniques
Covering:
1. Medial/Lateral Gapping
a. Patient’s leg off the plinth with back to patient
b. Patient’s leg off the plinth between the operator’s knees
1st year techniques not included in this booklet
1. Patello-femoral joint
a. Medial/lateral glide
b. Superior/inferior glide
2. Hyperextension
3. Flexion
4. Medial/Lateral Rotation
5. Superior tibia-fibula joint
6. Anterior/Posterior shift
7. Medial / Lateral gapping
a. Patient’s leg elevated
i. Same side
ii. Different sides (1st year)
Key Points
 Begin your examination by comparing
o Alignment of the legs, for example is one externally rotated?
o Swelling (especially in the suprapatella pouch)
o Redness
o Heat (palpate with back of hand)
o Lumps and bumps
 Look at the muscles to see how any tension is affecting the knee
 Joint examination should begin with table techniques ie) everything
without lifting the knee in to flexion to avoid hurting a patient’s bad knee
 Remember that flexion of the knee begins as soon as you pick it up so
be careful
 An optional hand hold is to grip the calcaneus when putting into
dorsiflexion
 When you gap, be sure to repeat the gapping movement several times
to gather information about the joint.
 When you gap you may choose to try gapping in varying degrees of
flexion and extension / external and internal rotation.
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will donate at www.justgiving.com/SP2Technique
Medial/Lateral Gapping: Back to Patient
1.
2.
3.
4.
Patient lies supine
Op turns their back on the patient
Bring patient’s thigh near to the plinth edge so the leg is off the plinth
Fix on medial aspect of distal femur so the patient’s thigh is clamped between op’s
thigh and op’s hand
o The op should flex the elbow if possible to ensure a strong fix
5. Op grips the distal tibia and puts in to a small amount of flexion
6. Op moves tibia in a medial/lateral gapping movement
o The op should try this in varying degrees of flexion/extensio and
internal/external rotation
Medial/Lateral Gapping: Between the Knees
1.
2.
3.
4.
Patient lies supine
Op faces patient
Op Grips the patient’s distal tibia between their knees
Using phenar eminences grip either side of the tibia and do medial/lateral gapping
o Maybe put some traction or circumduction through as well
These documents were produced by BSO students to raise money for charity. We hope you
will donate at www.justgiving.com/SP2Technique