Knee 3 (test 3) Flashcards
(43 cards)
prevalence of meniscus injury
2nd most common knee injury
medial is injured more than lateral
posterior horn > anterior horn
risk factors for meniscus injury
acute injury = all WBing sports
degenerative injury
-older age
-male > female
-work related kneeling/squatting/stair climbing
a greater time elapsed from any knee injury
describe the meniscus
nearly circular wedge shaped fibrocartilage disks on tibial plateau
attached to tibia via horizontal coronary ligaments
function of meniscus
stability > shock absorption
deepen joint surface for stability
outer 1/3 is 80% type 1 collagen
inner 1/3 is 60% type II and 40% type I
describe the medial meniscus
more O shaped
torn more frequently
attachment to MCL
describe the lateral meniscus
more C shaped
greater mobility without ligamentous attachment
symptoms of meniscal injury
joint pain; could refer to shin
limited and painful motion
limits with WBing + possible catching/locking
onset of meniscus
if acute = trauma; probably weight bearing sport
chronic = gradual/unkown; usually with older people and w/o prior injury
signs of meniscal tear
swelling
asymmetrical/antalgic gait
limited/painful ROM (depends on where tear is)
weak and painful resisted testing
pain with compression
special tests for meniscus
meniscal CPR
McMurrays
Eges
Thessaly’s (lateral only)
findings indicated by Apleys test
distraction = ligament
compression = high specificity for meniscus
what would MMT and palpation show if meniscus is involved
possible joint line tenderness with palpation
inhibited quads with MMT
effectiveness of an MRI
in a study with 44 asymptomatic 20-68 year olds 98% had a meniscal abnormality and 61% had abnormalities in 3/4 meniscal regions
**some people can have majority of meniscus changed and still have no symptoms…
PT Rx for meniscus
POLICED = WEAK support
assistive device to prevent limp
JM
MET
purposes of JM for meniscus
pain modulation via descending pathways
meniscal integrity
purposes of MET for meniscus + effectiveness compared to sx
meniscal integrity and stabilization
NMES has moderate support for strength
equally as effective as sx in regards to pain with degenerative tears
less anxiety/depression vs sx
what is a partial meniscectomy + the associated post op aspects
removal of tear
post op:
-no immobilization
-earlier WBing
-return to play within 2-6 weeks
what is a meniscal repair + associated post op aspects
sutured
post op:
-primarily with tears in outer 1/3
-immobilization and/or limited ROM initially
-toe touch WBing for 4-6 weeks
-return to play in ~ 12 weeks (dense healing)
effectiveness/support of sx for degenerative tears
sx no better at 2, 6, or 12 months vs sham (placebo) sx without ARJC
strong recommendation against sx for nearly all degenerative tears even in the presence of age related joint changes
what is a bakers cyst
excessive swelling in popliteal space often due to articular changes (i.e. ARJC)
fluid filled cyst due to persistent inflammation and subsequent weakening of capsule
a herniation of fluid through posterior capsule
signs and symptoms of a bakers cyst
asymptomatic until there is significant effusion
mimics degenerative meniscus tear
ROM limited and painful with flexion and extension
resisted/MMT into flexion is painful
palpable popliteal protrusion just medial to medial gastroc head
PT Rx for bakers cyst
like degenerative meniscal tear/ARJC
precautions with forceful activities
big picture = reduce swelling to get better stability/ROM/etc
**stretch of capsule cant be addressed conservatively
prognosis for bakers cyst
difficult to manage in active individuals
complication: rupture may occur and mimic a gastroc tear
MD Rx for bakers cyst
aspiration and/or surgical repair
