- PCL - Patellar fracture - Tibial Plateau Fracture

Exam 1 Flashcards by Wei Xu

varus / valgus without rotation

Collateral ligaments
Patellar Dislocation

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Varus/ valgus with rotation

Collateral ligaments
Cruciate ligaments
Patella dislocation
Meniscus

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AP force with knee flexed or fall on flexed knee with foot in DF

Osteochondral Fracture

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AP Force with knee flexed or fall on flexed knee with foot in PF

Posterior cruciate ligament

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Contact Hyperextension

ACL / PCL

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Non-contact Hyperextension

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Non-contact Deceleration / Cutting

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Non-contact Rotation with varus/valgus

Meniscus
ACL
MCL
LCL

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Non-contact rotation with compression

Meniscus
Osteochondral Fracture

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Hyperflexion

ACL
Meniscus

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Dashboard Injury

PCL
Patellar fracture
Tibial Plateau Fracture

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Forced Medial Rotation

Lateral meniscus

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Forced Lateral Rotation

Medial meniscus, ACL, MCL

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Ligaments injury are mostly?

Traumatic, not overuse

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Posteromedial joint line

medial meniscus

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Medial Knee

ACL, MCL, MM, Pes Anserine, or OA

Anterolateral joint line

lateral meniscus

Lateral Knee

LCL, LM, ITB, or OA

Anterior Knee

PFPS

Posterior Knee

Joint effusion
Mild Gastroc strain
PCL Tear

Deep Knee Pain

Cruciate ligaments, Meniscus, OA

Sharp, catching pain, locking

structural problem
Meniscus lesion

Ottawa Knee Rules states X ray should be performed if

Age greater than 55
isolated patellar tenderness
tenderness of the fibular head
inability to flex the knee to 90 degrees
inability to bear weight immediately after injury

Gait cycle on the involved leg with damage

limited stance phase with lengthened swing phase

Classification of Effusion

- Trace: small wave on medial side with down-stroke - 1+ : Larger bulge on medial side with down-stroke - 2+ : Effusion spontaneously returns to medial side after upstroke - 3+ : So much fluid that isn't possible to move the effusion out of the medial knee

Knee Capsular Pattern

More flexion loss than extension

Lateral Rotation

MCL, LCL

Medial Rotation

ACL, PCL

Bundles of ACL

- anteromedial - posterolateral

History of ACL

- mainly non contact but can be contact - Femoral IR with foot planted (Knee ER) - WB instability, inability to continue to play

ACL evaluation

- Segond fracture at lateral tibial condyle - injury to the lateral capsule - Resisted isometrics would be strong & painless - Hypermobile and painful joint play

What does Pivot shift test?

- Anterolateral instability - Lateral tibial plateau subluxates in extension

Decision making for a patient with an ACL tear is?

biased toward surgical reconstruction

ACL classification

- Non-coper: cannot return after injury, knee giving away - Adapter: adapt to less intense activities to avoid - Potential Coper: good potential to cope with ACL deficiency - Coper: can resume all preinjury activities

ACL copers

- no or mild knee effusion - full active knee ROM - At least 70& Quad strength - no knee pain - can hop on involved knee

Phase I goals for ACL non-operative rehab

- reduce swelling & inflammation - normalize knee motion (primarily extension)