Knee Flashcards

1
Q

how would you decrease risk for ACL injury

A
  • focus on strength, neuromuscular control, balance
  • series of different programs which address balance board training, landing strategies, plyometric training, and single leg performance
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2
Q

examples of acute knee injuries

A
  • ligamentous sprains
  • mm strains
  • contusions
  • meniscal tears
  • patellar dislocation
  • fracturess
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3
Q

examples of chronic knee conditions

A
  • patello-femoral pain syndrome
  • bursitis
  • patellar tendonitis
  • Osgood Schlatter’s disease
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4
Q

general ligamentous sprains - grade 1

A
  • no tearing
  • no laxity
  • mild stretching
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5
Q

general ligamentous sprain grade 1 - management

A
  • rest from sport 7-10 days
  • RICE
  • therapeutic modalities
  • ROM and strengthening ex
  • balance and prop ex
  • maintain CR fitness (first thing that starts to deteriorate)
  • tape for support
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6
Q

general lig sprain - grade 2

A
  • moderate damage with partial tearing
  • some joint laxity present, but solid end feel noted
  • slight swelling and increased pain
  • moderate to severe joint tightness, decrease ROM
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7
Q

management of general ligamentous sprain - 2nd degree

A
  • POLICE 48-72 hours
  • crutch use during acute phase
  • rest from sport 2-4 weeks
  • may brace prior to initiation of ROM ex
  • gradual progression from isometric ex to closed kinetic chain progression activities
  • maintain/regain CV conditioning/balance
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8
Q

general ligamentous sprain - 3rd degree

A
  • complete tear of supporting ligaments
  • complete loss of stability during motion
  • loss of motion due to effusion & guarding
  • immediate pain that builds as swelling increase
  • no ligamentous end feel at passive end range
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9
Q

management ligamentous sprain, 3rd degree

A
  • RICE
  • conservative vs surgical approach
  • limited immobilization with a brace
  • progressive wbing and increase ROM over 4-6 weeks
  • progress as per 1st and 2nd degree sprains
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10
Q

MCL sprain - etiology

A

result from blow to lateral side causing tension on medial knee (valgus force)

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11
Q

S&S MCL sprain

A
  • swelling and pain dependent on severity

- pain on medial aspect of knee

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12
Q

Etiology - LCL sprain

A
  • result of varus force, generally w/ tibia internally rotated
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13
Q

S&S LCL sprain

A
  • pain, tenderness and swelling lateral joint line over LCL

- may cause irritation of peroneal nerve

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14
Q

ACL sprain etiology

A
  • caused by direct contact or by a non-contact mechanism

- 80% of cases result of non-contact

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15
Q

ACL sprain - MOI

A
  • deceleration
  • hyperextension
  • foot contacts the ground with the heel, or in a flat foot
  • unhappy triad
  • anterior force to tibia with the knee flexed to 90
  • IR of leg w/ body in ER
  • leg ER with valgus force
  • cutting
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16
Q

sex differences - ligamentous sprains - ACL

A
  • female athletes are 3-5 more likely to suffer an isolated ACL injury compared to men
  • 1 - hormonal influence
  • 2 - anatomical- women smaller ACL than men, smaller intercondylar notch
  • 3 - neuromuscular risk factors: these include things like core stability, strength, proprioception, or inter-muscular coordination and firing rate
17
Q

S&S ACL sprain

A
  • experience pop w/ severe pain and disability
  • sudden giving away and inability to WB
  • positive special tests
  • rapid swelling at the joint line peaking 24 - 48 hours after
18
Q

S&S Meniscal injuries

A
  • effusion developing over 48 - 72 hour period
  • joint line pain and loss of motion
  • intermittent locking and giving way
  • pain w/ squatting
  • portions may become detached causing locking, giving way or catching within the joint
  • if chronic, recurrent swelling or mm atrophy may occur
19
Q

patellar dislocation - etiology

A
  • deceleration w/ simultaneous cutting in opposite direction (valgus force at knee)
  • direct blow to patella when knee is flexed and planted
  • quad pulls patella out of alignment
  • some individuals may be predisposed
  • increased Q angle
  • repetitive subluxation will stress medial restraints
20
Q

S&S patellar dislocation

A
  • pain and swelling
  • restricted ROM
  • results in total loss of function
21
Q

patellar dislocation management

A
  • immobilize
  • RICE
  • immediate medical attention
  • immobilization 4-6 weeks with crutches
  • muscular strengthening
22
Q

fracture - patella etiology

A
  • direct or indirect trauma (severe pull of tendon)

- semi flexed position with forcible contraction (falling, jumping, or running)

23
Q

S&S fractured patella

A
  • generalized joint swelling

- pain, disability, and potential deformity

24
Q

patella fracture

management

A
  • x ray necessary for confirmation of findings

- RICE and splinting if fracture is suspected

25
Q

osgoode-schlatter’s disease - etiology

A
  • traction injury

- repetitive stress on immature tibial tuberosity from quad contractions

26
Q

S&S osgoode-schlatter’s disease

A
  • swelling
  • point tenderness at tuberosity
  • enlarged and bony deformation
  • pain with kneeling, jumping, running
27
Q

management osgoode-schlatter’s disease

A
  • RICE
  • activity modification
  • Cho Pat brace
  • isometric for quads and hams
28
Q

patellofemoral pain syndrome etiology

A
  • joint aggravation d/t flexion/extension stresses
  • underside of patella or femoral condyles
  • result of lateral deviation of patella while tracking in femoral groove
  • tight structures, pronation, increased Q angle, insufficient medial musculature
29
Q

S&S patellofemoral pain syndrome

A
  • tenderness of medial facet during running, jumping, squatting, stairs
  • dull ache in center of knee
  • patellar compression will elicit pain and crepitus/grinding
  • move goer’s sign
  • overpronation
30
Q

patellofemoral pain syndrome - management

A
  • RICE
  • activity modification
  • wearing patellar brace or McConnell tape job
  • correct biomechanical issues/strength/flexibility
31
Q

patellar tendonitis -

A

• “Jumper’s knee”
• Results in pain in one or more of the following:
a) The inferior pole of the patella
b) The mid tendon region
c) The insertion at the tibial tuberosity

32
Q

patella tendonitis - etiology

A
Etiology
• Jumping or kicking
• Over-pronation
• Running on hard surfaces; rapid increase in running
• Sudden or repetitive extension
33
Q

S&S Patellar tendonitis

A
  • 1) pain after activity,
  • 2) pain during and after,
  • 3) pain during and after (possibly prolonged) and may become constant
34
Q

management of patellar tendonitis

A
  • RICE
  • therapeutic modalities (heat)
  • exercise
  • patellar tendon bracing
  • transverse friction massage
  • eccentric strengthening - stop and drops
35
Q

ITband friction syndrome etiology

A
  • caused by repetitive/overuse conditions; structural mal-alignment, structural asymmetries , training errors
  • leg length discrepancy
  • genu varum
  • over pronation
  • sudden TFL/glute max
  • hip weakness
36
Q

MOI OITband syndrome

A

compressive and friction forces to lateral femoral condyle

37
Q

S&S ITB syndrome

A

pain after running, going up or down stairs, point tenderness at Gerdy’s tubercle

38
Q

ITB friction syndrome - management

A
  • RICE
  • correction of mal alignment
  • proper warm up and stretching
  • activity modification
  • orthotics