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CD2203- Final > Knee 2 > Flashcards

Knee 2 Flashcards

1
Q

prevalence of Patellafemoral pain syndrome (PFPS)

A

40% of adults with reported knee pain (25% of all running injuries)

-overuse type injuries

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2
Q

what facet of the patella is most commonly associated with chondromalacia patella

A

odd facet (most medial)

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3
Q

what mechanical advantage does the patella provide

A

improves efficiency of extensor mechanism (last 30 degrees of extension)

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4
Q

Biomechanics of the patella @ flexion/ext

A

At 0 degrees- no contact of patella in femoral groove

at 120 degrees- odd facet makes contact in femoral groove (sitting tends to aggravate petelofemoral pain)

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5
Q

patella fx exam findings

A
  • trauma hx
  • swelling
  • inability to weight bear
  • Bony tenderness/ palpable cleft
  • inability to perform aslr
  • decreased knee flexion
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6
Q

what is the criteria to make a dx of PFPS

A
  • Presence of retropaterllar/ peripatellar pain
  • reproduction of pain w squatting, stair climbing, prolonged sitting
  • patellar tilt test with the presence of hypo mobility
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7
Q

clinical stages of chondromalacia patella (4)

A
  1. softening, swelling, blistering of articular cartilage
  2. Fissuring of articular cartilage (clefts)
  3. Fibrillation (crabmeat sign)
  4. Thinning of articular cartilage
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8
Q

theory of causes of chondromalacia

A
  1. abnormal patella excursion
  2. abnormal patellofemoral pressure
  3. trauma
  4. genu valgus
  5. patella alta
    or just normal
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9
Q

signs/symptoms of chondromalacia patella- mc cohort

A

runners 20-30

s/s- recurrent effusion, coarse creapatis, night pain, pain with prolonged sitting

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10
Q

chondromalacia patella exam findings

A

+ patella compression
+squatting
+Clarks sign
+ resisted knee extension

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11
Q

conservative management and prognosis of chondromalacia patella

A
  • CKC exercises: semi squats to stegthen VMO
  • ITB stretching
  • US
  • Infrapatellar strap

6-8 weeks conservative= good in >50% pts.

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12
Q

Patellaofemoral malalignment syndrome

A

-tracking problem (pain in retropatellar area*)

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13
Q

Postural characteristics associated with patellofemoral malalignment syndrome

A
  • femoral anteversion
  • increase q angle
  • hyperextension @ knee
  • tibia varum (angled in)
  • tibial tortion
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14
Q

Signs of patellofemoral malalignment syndrome

A 
\+ patella compression
crepatus
\+ pain on ascending/descending stairs
\+ clarks sign
\+ patellar tilt test 
\+ resisted extension
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15
Q

normal q angle males + females

A

males= 13-18

females 18

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16
Q

what does a patellar tilt test indicate usually

A

inability to lift lat border of patella (indicates tight lat reticulum + likely lat tracking)

17
Q

tx and prognosis of patellofemoral malalignment syndrome

A

-isometric ex for VMO
-stretch ITB/hams/quads
-6-8w
good prognosis

18
Q

What is the most common ethology of patellar sublet/dislocation and moi

A

inadequate quadriceps strength

moi- Ext rot of leg, contraction of quad and ext of knee. Pivoting to one side

19
Q

s/s of patella dislocation/sublux

A

-loud sound @ time of injury
-may spontaneously reduce
-swelling occurring rapidly within minutes (large hemarthrosis)
+aprehension sign
tender medial retinaculum

20
Q

fat pad impingement ethology

A
  • sudden forced knee extension
  • with repeated activity, there may hypertrophy so a portion of the tissue becomes pinched between the patella and the femur
  • overload syndrome
21
Q

S/S of fat pad impingement

A
  • tenderness on either side of patella
  • petellar compression + in lower pole
  • soft creates
  • faber
  • swelling/effusion
22
Q

patellar tendinitis (jumpers knee)- what is it, eitology

A

-Inflamation of the distal tendon of the quads (/anywhere along the extensor mechanism of knee)

  • overuse/overtraining
  • eccentric forces
  • running to fast/worse during running
23
Q

s/s of patellar tendinitis

A
  • ant knee pain
  • *pain and tenderness localized to the infra patellar pole (quad tendon)
  • clarks sign +
  • knee flexion is painful
24
Q

what hip rehab is beneficial in PFPS

A

improve hip flexion strength combined with increased IT band and iliopsoas flexibility

25
Q

Triad of symptoms in osgood shlater

A
  1. Swelling over tibial tubercle
  2. point tenderness of tibial tubercle and patellar tendon
  3. xray-irregular ossification
26
Q

tx of osgood shlater

A

modify activity (but continue sport)
infra patellar strap
STT, PNF stretching
(US contra)

2-3m

27
Q

What is Larsen Johanssen disease (onset, pop, signs)

A

juvenile osteochondrosis that disturbs the patellar tendon attachment to the inf pole of the patella

  • adolescent boys
  • insideous
  • tenderness over inf pol
28
Q

What is osteochondritis dissicans- pathology and location

A
  • focal van of bone- lat part of medial femoral condyle, can cause a jt mouse
  • knee pain jt effusion, giving away catching, decreased rom, adolescent
29
Q

tx and prognosis of osteochondritis dissicans

A

prevent partial or complete detachment (pinning surg)
strengthening

good prognosis

30
Q

IT band syndrome eitology/predisposing factors

A

friction of repetitive knee flex/ext causing inflammation of bursae underlying distal portion of the ITB\

predisposing= old shoes, leg length, lack of stretching

31
Q

s/s of IT band syndrome

A

sharp pain over lateral femoral epicondyle posteriorly (superficial pain)

32
Q

synovial plica syndrome- which is most clinically sig + symptoms

A

medial patellar plica

  • anteromedial knee pain
  • pain aggravated by reparative activity
  • pain w sitting long
33
Q

synovial plica syndrome signs

A 
medial parapatellar pain 
pain or palpable band over medial condyle
snap or grinding w mcmurrays test
quad atrophy 
effusion
34
Q

definite indicators of synovial plica

A
  • present on orthography, ct, Sri
  • pain relieved by medial intracapsular cortisone
  • prolonged releif w medial intracasular cortisone
35
Q

symptoms of popliteus syndrome

A
  • pain, stiffness, fullness on back of knee
  • posterolat jt line pain
  • aggrevated by heal strike**

CD2203- Final (5 decks)

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