Acute Knee

Question 1

ACL injury
1. aggravates
2. ACL test

Answer 1

1. ext of knee, int rot of knee (can also be ext rot)
2. Lachman’s test: laying supine, leg abducted off table with thigh on but leg off, bend knee 20-30 deg flexion with foot between examiner’s leg, use one hand to steady femur and other hand compresses gastroc and put thumb on tibial tuberosity and pull ant in parallel dir of femur; working ACL should stop motion forward and feel firm
3. Anterior drawer: laying supine, 90 deg knee flexion, hold femur down with one hand, other hand compresses gastroc and put thumb on tibial tuberosity and pull ant in parallel dir of femur; working ACL should stop motion forward and feel firm

Question 2

PCL injury
1. aggravates
2. PCL test

Answer 2

1. flex knee, ext rot of knee (can also be int rot)
2. posterior drawer: laying supine, 90 deg knee flexion, place the thenar eminences of both hands against the anterior tibia, and push post in parallel dir of femur, on either side
   of the patellar tendon; working PCL should stop motion inward and feel firm

Question 3

menisci injury
1. aggravates
2. menisci test

Answer 3

1. compression, internal rot (lat meniscus), external rot (med meniscus)
2. McMurrays test: patient lying supine, bring knee into deep flexion to compress meniscus, externally rotate (medial) or internally rotate (lateral) to bias a side; feel for the meniscus as you extend the leg; a pop, jump or squishy feeling may indicate injury

Question 4

MCL injury
1. aggravates
2. MCL test

Answer 4

1. valgus
2. valgus test: abduct the hip so that the leg is hanging off the bed with the thigh on it, stand on lateral side of the leg with hip perpendicular to the femur at the knee and hold thigh in 20-30 deg flexion with hand at distal end of tibia and pull the tibia toward you, hold down the femur with the other hand and rotate the femur towards the medial side to apply valgus stress

Question 5

LCL injury
1. aggravates
2. LCL test

Answer 5

1. varus
2. varus test: abduct the hip so that the leg is hanging off the bed with the thigh on it, stand on the medial side of the leg with hip perpendicular to the femur at the knee and hold thigh in 20-30 deg flexion with hand at distal end of tibia, pull the tibia toward you, hold down the femur with the other hand and rotate the femur towards the lateral side to apply varus stress

Question 6

hamstring strength and injury tests

Answer 6

1. medial side: semimembranosus and semitendinosus; patient in prone; knee flexed 90 deg, rotate tibia internally to bias medial side, one hand on the thigh, ask patient to resist as you try to ext their leg with other; test bilat strength
2. lateral side: biceps femoris; patient in prone; knee flexed 90 deg, rotate tibia externally to bias medial side, one hand on the thigh, ask patient to resist as you try to ext their leg with other; test bilat strength
3. popliteal angle test: laying supine, one hand holding femur 90 hip flexion, hold distal tibia with other hand and ext their leg to max; measure popliteal angle (normal is around 145 deg; if less could be injury or stiffness)

Question 7

FADIR

Answer 7

test for hip impingement by flexing, abducting, and internally rotation hip; ask for pain or limited motion

Question 8

neuromuscular training programs in prevention of lower body injury

Answer 8

1. decrease incidence of knee injuries; incidence of program vs no program is 53% decrease from no program
2. program consists of plyometics, strength, aglity, balance, and give feedback on land (less valgus, hip in neutral rotation, increase knee flexion to land soft, land mid and fore foot, no over pronation or supination of foot)