Knee 2 Flashcards
1
Q
Which injury?
- Mechanism → rotational (twisting) or hyperextension force
- Sudden pain and giving way
- 1/3 report audible “pop”
- Rapid development of joint effusion and associated stiffness
- Majority involve a complete tear
- Associated meniscal tears are common
A
ACL tear
2
Q
Which injury?
Non-contact MOI
- Planting and pivoting
- Valgus loading in combination with internal rotation of the femur and external tibial of the tibia rotation
A
ACL
3
Q
Which injury?
Contact MOI
•Hyperextension force applied to the anterior aspect of the knee while the foot is planted on the ground
A
4
Q
Signs / Sxs of what injury?
- Rapid effusion
- Significant ROM limitation due to effusion
- Pain and feeling of instability w/ weight bearing
A
ACL Tear
5
Q
What 2 tests will be positive for ACL tear?
A
- Lachman test
- Anterior drawer
6
Q
ACL Tear Treatment
A
- Rest, ice and NSAIDs
- Aspiration if knee effusion (hemarthrosis) for symptom relief
- Knee immobilizer or hinged knee brace w/ crutches
7
Q
ACL Tear
- High risk for subsequent ___ tears and _____ in ACL deficient knees
- ACL reconstruction of _____ individuals
- Physical therapy aimed at controlling _____ for older/less active individuals
A
- meniscal tears & degenerative disease
- young / active
- instability
8
Q
- Are ACL or PCL tears more common?
- Are combined ligament injury tears or isolated PCL injuries more common?
A
- ACL
- combined
9
Q
Mechanisms of which injury?
- Dashboard injury → posteriorly directed force to anterior knee with knee in flexion
- Fall onto flexed knee with foot in plantar flexion
- Hyperextension injury to knee
A
PCL Tear
10
Q
PCL Tear
- Hyperextension injury to knee
- direct load on anteromedial proximal tibia w/ knee extension
- ___ ruptures first, followed by ____ rupture
- Frequently results in what?
A
- ACL first, then PCL
- Knee dislocation
11
Q
PCL tear
- Effusion within the 1st ___ hours
- Active & passive ROM limited due to effusion
- Pain and feeling of ___ w/ weight bearing
- What 2 tests are positive?
A
- 24 hrs
- instability
- Sag test / Posterior drawer
12
Q
PCL
- Radiographs to r/o _____ or ____
- ____ to confirm Dx
A
- avulsion injury / fx
- MRI
13
Q
PCL Tear Treatment (isolated PCL injury)
A
•Knee immobilizer progressing to hinged knee brace w/ crutches
Therapy
- Resolve swelling and restore ROM
- Strengthening exercises (quads)
- Functional bracing if returning to contact sports
- PCL reconstruction if recurrent instability and/or subsequent meniscal tears
14
Q
Diagnostic studies for what injury?
- Plain radiographs
- Arterial and venous Doppler US
- Ankle-brachial index
- Arteriogram
- MRI
A
Knee Dislocation
15
Q
Menisci
- Fibrocartilaginous pads
- Shock absorbers between ___ and _____
- Stiffness increases
- What 2 things decrease w/ age?
A
- femoral condyles & tibial plateaus
- reslience & vascularity
