Exam 2 Flashcards
what foot deformity is most common with patellofemoral pain?
forefoot varus
AKPS
- anterior knee pain scale
- outcome measure
- 100 max points (no pain)
patellofemoral pain often seen in:
runners
patellar tendinopathy often seen in:
jumping athletes
patellofemoral dislocation most common in:
adolescent age group during athletic activity
symptoms associated with patellofemoral pain syndrome:
- pain using stairs, running
- no trauma
- pain with prolonged sitting with knee flexed, relieved by extending knee
- anterior knee ache relieved by rest from aggravating activities
- anterior knee pain elicited during a squatting maneuver
symptoms of neuropathy of infrapatellar branch of saphenous nerve:
- could be injured during surgery, or from direct trauma
- nerve sensitive to palpation, and neuropathic pain “burning, tingling”
- allodynia
- can result in severe symptoms
- limited flexion
Ottowa Knee Rules
- age 55 or older
- isolated tenderness of the patella (no bone tenderness of knee other than patella)
- tenderness of head of fibula
- inability to flex to 90 degrees
- inability to bear weight both immediately and in the clinic for 4 steps
Red Flag for DVT
- pain or tenderness
- swelling, warmth, redness, discoloration
- distention of surface veins
Wells Score categorization
- high if greater than 2
- moderate if 1 or 2
- low if less than 1
symptoms of septic arthritis
- history of recent infections, recent surgery or joint infection, presence of prosthesis
- symptoms: constant throbbing, aching pain in joint even at rest, swelling and warmth
- may have systemic symptoms such as fever and chills, fatigue
- knee and hip most commonly affected
signs of osteochondral defect
- history of trauma involving rotation while knee is loading, landing from a jump
- pain with weight bearing
- locking
- crepitus
- pain and swelling after activity
- eased after unloading joint
osteochondritis dissecans most often develops in:
children and adolescents
contact area between patella and trochlea gradually increases as:
knee flexes
for rehabbing articular cartilage injuries, OKC ROM for exercise should be:
90-45 degrees
for articular cartilage injuries, CKC ROM for exercise progression:
initially: 0-30
as heals: 0-60
then 0-90
osteoarthritis risk factors
- increasing age
- obesity
- genetic predisposition
- inappropriate loading
rehab after partial menisectomy:
- WBAT immediately and progress to FWB
- restore full AROM ASAP, get quads firing immediately
- progress activity slowly according to pain, and swelling
- can return to full activity 2-4 weeks
rehab after meniscus repair
- WB restricted for 2-4 weeks
- ROM 0-90; not hamstring activity if medial meniscus
- start with iso quads immediately; progress after 4-6 weeks to knee ext PRE
- usually start functional training at 3 months and return to full around 6 months
If knee opens at 30 and 0 degrees during valgus stress test:
- then other ligaments are involved such as the ACL or PCL
- need to be referred for imaging
what percentage of ACL injuries are non-contact?
80%
recurrence (same side or opposite side) after ACL reconstruction?
29%
ACL graft strength timeline:
- strongest when first go in
- weaken over first 6-12 weeks
- gets stronger as revascularize (16 weeks)
- Maturation can take 12-18 months (still usually only 50% as strong as normal ACL)
knee posterolateral ligaments:
- LCL
- popliteus muscle-tendon ligament unit (includes popliteofibular ligament and posterolateral capsule)
At 0-70 degrees the quads create what kind of shear?
anterior shear
At flexion angles greater than 70 degrees the quads creat what kind of shear?
posterior shear
safest position for WB exercises after PCL injury?
0-70 degree since don’t strain the PCL (has an anterior shear on knee)
when are the quads an active agonist for PCL?
open chain exercises
when are the hamstrings active antagonist for PCL?
open chain exercises
