Knee Flashcards
Altmans criteria for knee OA
Over 50yo less than 30min morning stiffness crepitus bony tenderness bony enlargement no palpable warmth of synovium
Microfracture
Small lesions <2cm, no osseous defect.
Timeline: 8-17mo
OATS
Small lesions <2cm, contraindicated in larger lesions.
timeline: 6.5-7mo
Best for higher level athletes
ACI
focal lesions 1-10cm, failed microfracture or OATS.
Contraindicated for reiprocal lesions, presence of OA or inflam arthritis.
two surgeries
timeline: 18-25mo
Most common place for cartilage lesions in knee
medial femoral condyle
patellar surface
ACL bundles
Anterior medial: tight through flexion and IR
Posterior lateral: tight in extension until ~20deg flexion
PCL bundles
Anterolateral: 95% of substance, tight in flexion
Posteromedial: 5% of substance, tight in extension
MCL test
Valgus at 30deg flex
LCL test
Varus at 30deg flex
PCL test
most specific: post sag and quad activation test
ACL test
Lachman most specific (postlat bundle)
Posterolateral Corner test
Posterior drawer increased at 30, normal at 90
Most specific: prone ER test (dial test) >10deg compared to uninvolved side at 30deg flex
Meniscus testing
5/5 = 92% mensicus tear
- catching/locking
- pain with forced hyperextension
- pain with max passive knee flexion
- joint line tenderness
- pain/click w McMurray
Patellofemoral testing
Step-down test
patellar tilt test
Most specific: pain with resisted isometric quad contraction, squatting, palpation
Osgood-Schlatter Disease
traction apohysitis of patellar tendon insertion into tib tub.
during growth spurt, age 10-15, self limiting
