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MSK III P3 Fall > 5] Posterolateral Corner and 6] Articular Cartilage Injuries > Flashcards

5] Posterolateral Corner and 6] Articular Cartilage Injuries Flashcards

1
Q

6 deep layers of PLC

A 
FCL
Arcuate lig 
PFL
FFL (fabulous fib lig)
Popliteus muscle and tendon
Joint capsule
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2
Q

Attachment of Fibular collateral lig

A

Proximal femoral condyle to styloid

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3
Q

Force to failure for FCL

A

750 N

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4
Q

Attachments of popliteofibular lig

A

83 deg to popliteus to styloid

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5
Q

Force to failure for PFL

A

400 N

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6
Q

Attachments of popliteus

A

Lateral femur to medial tibia

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7
Q

Attachments of arcuate lig

A

Lateral capsule to posterior fibular head

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8
Q

Main cause of injury to PLC

A

Trauma

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9
Q

MOI (3) for PLC

A

Hyper extension
Hyperext with varus or ER
Hyperext with ER and knee flexed

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10
Q

What do plain films show for PLC

A

Wide joint spaces
Arcuate Fx
Gerry tubercle avulsion Fx
Second Fx

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11
Q

Best imaging view for PLC

A

MRI: coronal oblique T2

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12
Q

Acute complaints for PLC

A

Lateral knee pain

Peroneal nerve injury

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13
Q

Chronic complaints for PLC

A

Med/lat/post knee pain
Unstable
Neuro Sx
Functional limitations

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14
Q

5 instability tests for PLC

A 
Posterolateral drawer
Dial test (tibial ER)
ER recurvatum
Reverse pivot shift test
Varus at 0 and 30
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15
Q

Grade 1 PLC

A

Minimal tearing with no weird joint motion

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16
Q

Grade 2 PLC

A

Partial tear with slight-mod abnormal joint motion

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17
Q

Grade 3 PLC

A

Rupture with marked abnormal joint motion

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18
Q

Protected phase of non op txt

A

Immobilized for 2-3 weeks in hinged branch
WBAT gait training
Therex

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19
Q

Relative contraindications for protected phase

A

Control varus and tibial ER moments

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20
Q

Indications for surgery for PLC

A

Grade 3 sprain
Combined injury
Athlete

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21
Q

Post op rehab protective phase

A

Weeks 0-6
Protected WB locked in full ext with brace
30-110 deg
Isometric quad sets

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22
Q

Funcitonal phase of post op rehab for PLC

A

Weeks 7-12
0-120 deg at week 8
0-135 deg at week 12
CKC and balance exercises (NM trg)

23
Q

When do you start OKC hamstrings

A

Week 16 return to activity

24
Q

Running for PLC

A

4-6 months

25
Q

Return to sport for PLC

A

9-12 months

26
Q

Most common articular cartilage injury

A

Meniscus

27
Q

MOI for Chandra’s injuries

A

Acute trauma with hemarthrosis

Insidious onset with repetition

28
Q

Small lesion size

A

Less than 1.5 cm

29
Q

Preferred surgery for small lesion

A

Microfracture

30
Q

Medium lesion size

A

1.5 to 2.5

31
Q

Surgery for medium lesion

A

Osteochondral autogenous transfer (OATS)

32
Q

Large lesion size

A

2.5 to 4

33
Q

Surgery for large lesion

A

ACI (autogenous cartilage implantation)

34
Q 
Failed microfracture/OCD
Large lesion
More than 6mm bone loss
15-55 years old
Normal alignment 
Stable
BMI less than 40
No swelling
Not sensitive to bovine serum
A

Indications for ACI surgery

35
Q

Athletes age

A

Slower cartilage repair with increased age

36
Q

BMI

A

More gradual rehab progression with BMI more than 30

37
Q

Type of sport

A

Higher demand on tissue in impact sports

38
Q

Repair technique

A

More rapid progression wit restorative technique

39
Q

Defect location

A

Immediate WB for PF defect (locked in full extension)

40
Q

Cartilage quality

A

Slower rehab progress with general joint chondropenia

41
Q

Meniscus status

A

Slower rehab progress after meniscectomy (esp lateral meniscus)

42
Q

Overload principle

A

Decreased GAG concentration
Improves knee joint levels
Decreases cartilage thickness

43
Q

Milestones of protection and joint activation phase

A 
Full PROM
Minimal to no pain (VAS < 3)
Trace to no effusion
Recovery of muscle activation
Normal gait
44
Q

Milestones of progressive joint loading/functional restoration

A 
Full PROM
VAS less than 3
Less than 1+ edema
Quad strength less than 10% diff
Hop performance less than 10% diff
PROs more than 90%
Jog at 8 km/hour (5 mph) > 10 min?
45
Q

Effusion spontaneously returns to medial side after upstroke

A

2+

46
Q

Not possible to move effusion

A

3+

47
Q

Large bulge on medial side with downstroke

A

1+

48
Q

Small wave on medial side with downstroke

A

Trace

49
Q

Sore during warmup that continues

A

2 days off

Drop 1 level down

50
Q

Sore durign warmup that goes away

A

Stay

51
Q

Sore durign warm up that goes away but comes back during session

A

2 days off

Drop down 1 level

52
Q

Sore the day after lifting

A

1 day off

Don’t advance

53
Q

No soreness

A

Advance 1 level/week as instructed by healthcare professhhh

MSK III P3 Fall (19 decks)

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