Injuries to the Knee Flashcards
Sprain of MCL
Valgus instability
Medial Collateral Ligament (MCL)
MCL MOI
blow to the lateral side of the knee producing valgus stress
foot fixed w/ internal femoral rotation at the knee
overuse as w breast stroke in swimming
- a few ligamentous fibers are torn & stretched
- no instability
- little or no joint swelling
- joint stiffness/point tenderness below the joint line
- almost full active and passive ROM
- Return in 1-3 weeks
Grade I: SS of MCL
- partial tear
- some laxity
- some swelling with loss of passive ROM
- moderate to severe joint tightness w inability to actively extend knee
- pain & point tenderness (at or below joint line)
- return in 2-4 weeks
Grade II: S/S of MCL
- total rupture of ligament
- gross laxity
- minimum to moderate swelling
- loss of ROM
- pain & point tenderness
- return in 4-6 weeks
Grade III: S/S of MCL
MCL TX
- PRICEMM
- Crutches & Brace (for grades 2 & 3)
- proper rehab (ROM work and strengthening to the quadriceps)
- no surgery recommended (grade 3)
MCL DIAG
Valgus Stress Test
Sprain of LCL
Varus instability
Lateral Collateral Ligament (LCL)
LCL MOI
direct blow to the medial side of the knee
ER of femur & fixed foot
LCL S/S
pain
point tenderness along the joint line
joint instability depending upon degree
minimum swelling
LCL TX
similar to that of a MCL
LCL DIAG
Varus Stress Test
Sprain of ACL
most commonly disrupted ligament in the knee
Anterior Cruciate Ligament (ACL)
ACL MOI
Direct blow (hyperextension of valgus)
Rotational force
ACL S/S
audible “pop”
rapid swelling
pain initially that may diminish
instability
O’Donaghue’s version (OLD) of Unhappy Triad
combination of ACL, MCL, & MEDIAL meniscus
Recent version of Unhappy Triad
combination of ACL, MCL, & LATERAL meniscus
ACL TX
PRICEMM
Refer to MD
Crutches
Brace
ACL Anterior Drawer Test
- w/ foot point straight: ACL only
- w/ leg internally rotated 20 degrees: ACL & posteroLATERAL aspect of joint capsule
- w/ leg externally rotated 15 degrees: ACL & posteroMEDIAL aspect of joint capsule
ACL Lachment Test
ACL & PCL tear
ACL Pivot Shift Test
anterolateral rotary instability
ACL DIAG(S)
- Anterior Drawer Test
- Lachman Test
- Pivot Shift Test
ACL Surgery
Patellar Tendon Graft
Patellar Tendon Graft
middle of 3rd of the patellar tendon
Sprain of PCL
Posterior instability
not a v common injury
Posterior Cruciate Ligament
PCL MOI
force applied to the front of a bent knee; hyperextension; rotational force
tightest at 90 degrees = more susceptible to injury = automobile accidents
Posterior Cruciate Ligament (PCL)
S/S of PCL
pain
swelling
instability
TX of PCL
PRICEMM
refer to MD
crutches
brace
PCL DIAG(s)
Lachman Test
Posterior Drawer Test
Gravity (Sag) Drawer Test
Posterior Drawer Test
PCL tear
v easy test
PCL
Gravity (Sag) Drawer Test
T/F: You can damage PCL & never know it
True
tearing ligaments = worry about bld vessels = losing limb
Bad Injury
Dislocated Knee
Torn Cartilage
Meniscal Injuries
Meniscal Injuries MOI
rotational force
valgus/varus force
squatting hyperextension
cutting motion
forceful knee extension
S/S of Meniscal Injuries
Severe Pain
Loss of Function
Locking up of Knee
Clicking Sensation
TX of Meniscal Injuries
PRICEMM
refer to MD
Surgery possible
2 surgeries possible for Meniscal Injuries
- Meniscectomy
- Repair
surgery that treats the damaged piece; not the whole meniscus
meniscectomy
Meniscal Injuries DIAG(s)
McMurray’s Test
Apley’s compression Test
Apley’s Distraction Test
torn cartilage test for Meniscal Injuries
Prof’s fav
McMurray’s Test