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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
Return to sport for PLC
9-12 months
26
Most common articular cartilage injury
Meniscus
27
MOI for Chandra’s injuries
Acute trauma with hemarthrosis | Insidious onset with repetition
28
Small lesion size
Less than 1.5 cm
29
Preferred surgery for small lesion
Microfracture
30
Medium lesion size
1.5 to 2.5
31
Surgery for medium lesion
Osteochondral autogenous transfer (OATS)
32
Large lesion size
2.5 to 4
33
Surgery for large lesion
ACI (autogenous cartilage implantation)
34
``` 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 ```
Indications for ACI surgery
35
Athletes age
Slower cartilage repair with increased age
36
BMI
More gradual rehab progression with BMI more than 30
37
Type of sport
Higher demand on tissue in impact sports
38
Repair technique
More rapid progression wit restorative technique
39
Defect location
Immediate WB for PF defect (locked in full extension)
40
Cartilage quality
Slower rehab progress with general joint chondropenia
41
Meniscus status
Slower rehab progress after meniscectomy (esp lateral meniscus)
42
Overload principle
Decreased GAG concentration Improves knee joint levels Decreases cartilage thickness
43
Milestones of protection and joint activation phase
``` Full PROM Minimal to no pain (VAS < 3) Trace to no effusion Recovery of muscle activation Normal gait ```
44
Milestones of progressive joint loading/functional restoration
``` 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
Effusion spontaneously returns to medial side after upstroke
2+
46
Not possible to move effusion
3+
47
Large bulge on medial side with downstroke
1+
48
Small wave on medial side with downstroke
Trace
49
Sore during warmup that continues
2 days off | Drop 1 level down
50
Sore durign warmup that goes away
Stay
51
Sore durign warm up that goes away but comes back during session
2 days off | Drop down 1 level
52
Sore the day after lifting
1 day off | Don’t advance
53
No soreness
Advance 1 level/week as instructed by healthcare professhhh

MSK III P3 Fall (19 decks)

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