Knee 1

Question 1

knee pain lifetime prevelence

Answer 1

45%

Question 2

Red flags for lower extremity injuries

Answer 2

• Ottawa ankle rules
• Ottawa knee rules
• dislocation of tibiofemoral jt
• legg calves perth, slipped capital, congenital dysplasia

Question 3

Ottawa knee rules

Answer 3

1. > 55
2. knee flex <90
3. Tenderness patella/fib head
4. inability to walk 4 steps

Question 4

What forces does the med and lat meniscus withstand

Answer 4

med- compressive

lat- torsional forces

Question 5

What part of the menisci are typically pain generators an what lig can be a pain generator

Answer 5

post parts of menisci more vulnerable to injury
coronary lig (attach menisci to post tin plates) is innervated and can be pain generator

Question 6

2 biomechanics knee movements

Answer 6

rocking- first 15-18

gliding- 15-135

Question 7

What is the screwhome mechanism of the knee when non weight bearing and weight bearing

Answer 7

non- upon ext of knee, tibia rotates ext relative to femur

weight- upon ext of knee, femur rots int relative to tib

Question 8

How do the menisci move during flexion

Answer 8

move post during flexion of knee

Question 9

Ratio of med to lat menisci injuries

Answer 9

5:1

Question 10

What injuries are the lat meniscus more associated with

Answer 10

Discoid meniscus

meniscal cyst

Question 11

MOI for meniscal injury (3)

Answer 11

compression
torsional
combo of compression/torsional force

Question 12

What type of meniscus tear causes inability to fully extend especially during walking

Answer 12

Bucket handle tear

Question 13

Symptoms of meniscal injury

Answer 13

• hx of trauma (knee twisting)
• severe pain acutely
• pain localized to jt line (mc)

Question 14

Signs of meniscal injury

Answer 14

• effusion (capsular)
• Decreased ROM (flex/ext- ext lag)
• may not be able to fully weight bear

Question 15

What combo of tests should be used for meniscus injury

Answer 15

Mcmurrays, JLT and apleys

Question 16

what is the gold standard imaging for meniscal lesions

Answer 16

mri

Question 17

what is the prognosis of partial and total meniscectomy

Answer 17

partial- good prognosis

total- increased incedence of oa

Question 18

mc and 2nd mc moi for acl injury in contact sports

Answer 18

1. clipping- valgus loaf and ext rot of tibia

2. Hyperextension

Question 19

3 common moi for acl injury in non contact sport

Answer 19

1. skiing injury (digging tip)- ext rot + valgus
2. deceleration injury- ant force on prox tibia due to quad contraction
3. hyperextension

Question 20

symptoms of ACL tear and what does 75% of cases show

Answer 20

• loud snap/pop
• immediate onset of pain (or no pain?)
• 75% of cases w hemarthrosis

Question 21

signs of ACL tear

Answer 21

• unable to weight bear
• large knee effusion
• decreased ROM
• ACL tests +

Question 22

what is the 3 degrees of ACL tear

Answer 22

grade I- ant translation of tibia up to 5mm
grade II- ant translation of tibia up to 5-1cm
grade III- ant translation >1cm

Question 23

conservative tx of grade 1/2 acl tears

Answer 23

-rest/ice
-pain modalities
-ultrasound
-mobs
-bracing
3-6 weeks active rehab

Question 24

prognoisis of acl rehab (time line as well)

Answer 24

• good to fair

- 5-8 months if they require surgery

Question 25

What gender is more susceptible to acl injuries and what are the intrinsic reasons for it

Answer 25

intrinsic- Smaller intercondylar notches, loose jointedness, effect of horomones on ligamentous tissue (no apparent relation between q angle and ACL injury)

Question 26

Cyclops lesion and sign for it

Answer 26

complication of acl reconstruction -rounded fibrous mass sitting in the ant intercondylar notch sign- may have extension lag

Question 27

What is a segond fx and what is it associated w

Answer 27

avulsion fx of the knee which involves the lat aspect of tibial plateau (associated w ant cruciate lig disruption)

Question 28

MOi, hx, signsof PCL tear

Answer 28

moi- post force on prox tibia vague symptoms but often present with patellofemoral symptoms MILD swelling, nearly full rom

Question 29

Non operative vs operative PCL

Answer 29

non- treatment success 85% for grade 1/2 opperative- early PCL reconstruction surgeries yield best results

Question 30

What do you need to rule out in mcl/lcl lesions

Answer 30

xray to rule out fx and pellegrini sited lesion

Question 31

All 3 grades of mcl injury require what type of treatment

Answer 31

non operative** | rice, knee brace, electrotherapy, rom ex, strengthening, closed chain ex

Question 32

treatment of LCL injuries

Answer 32

grade 1/2- non operative (rice, knee brace, ex etc) Grade 3- Operative