Knee 1

Question 1

Functional ROM for gait

Answer 1

60 degrees flexion

10 degrees extension

Question 2

why is functional knee extension crucial for the gait cycle

Answer 2

due to tibial ER with screw home mechanism

if knee doesnt reach full extension then ankle may become hypermobile

hip wont compensate because it needs to IR when knee ER happens at heel off

Question 3

Why does the screw home mechanism occur

Answer 3

surface of articular cartilage is larger on the medial

means tibia has more joint surface to move on and thus externally rotates

Question 4

ROM required for stair descent

Answer 4

90 degrees of flexion (but would look funny)

120 is more realistic

Question 5

ROM needed to stand from a toilet or low chair

Answer 5

105 degrees of flexion

Question 6

120 degrees of flexion is significant for what

Answer 6

most going to be expected from a total knee replacement

also value needed for cycling

Question 7

Kneeling and deep squatting requires what

Answer 7

full flexion

Question 8

describe the arthrokinematics from 90 to 150

Answer 8

Femur ER and posterior glide

goes against other arthrokinematics with rest of range

if someone is struggling to obtain deep squat, can improve posterior glide

less than 3 degrees of both abduction and lateral glide also occur

Question 9

what is a sprain

Answer 9

stretching or tearing of ligament that may lead to some degree of joint laxity and dysfunction

Question 10

what is joint instability; functional vs mechanical

Answer 10

instability = increased AM and inadequate neuromuscular function

functional = can offset with neuromuscular function

mechanical = unable to offset; likely requires sx

Question 11

what is a grade 1/1st degree sprain

Answer 11

mild S&S

activity may continue

fibers stretched but not torn so there are minimal to no change during ligamentous special tests

Question 12

what is grade 2/2nd degree sprain

Answer 12

moderate S&S

activity stops

fibers stretched and torn so increased laxity occurs with softer/later end feel during ligamentous tests

Question 13

what is grade 3/3rd degree sprain

Answer 13

severe S&S

activity stops

fibers torn completely with possible avulsion

significant increase in laxity with empty end feels during ligamentous tests

Question 14

characteristics of ligaments and capsules

Answer 14

dense connective tissue

type I collagen that resists tension

low elastin (better stabilization)

fibrocytes

more multidirectional fibers than tendons

Question 15

describe the mid substance ares of ligaments/capsules

Answer 15

hypovascular and hyponeural

Question 16

describe the insertional ends of ligaments and capsules

Answer 16

hypervascular = hight metabolic activity so greater healing capacity

hyperneural = good for proprioception or position sense

Question 17

what is the difference between intra vs extraarticular sprains

Answer 17

extra = blend with capsule and often heals without sc

intra = within jt space and often need sx for repair due to dilution from synovial fluid

Question 18

initial tensile strength for sprians occurs when

Answer 18

3-5 weeks

Question 19

dense connective tissue for sprains occurs when

Answer 19

around 12 weeks

Question 20

normal strength postop is generally achieved when

Answer 20

10-12 months to normal strength

some may return to play at 6 months but for every month after 9 months the risk of reinjury lessens by 50%

Question 21

what is the distinctive Rx for sprains

Answer 21

POLICED

MET for primarily tissue proliferation and integrity and stabiliztaion