Knee Flashcards
Perform knee flexion APR
Test A/P Knee flexion ROM
Resisted extension
Perform knee extension APR
Test A/P knee extension ROM
Resisted flexion
Circumferential measurements of the knee
Tests effusion
Objective measure for maximally effused knee
Ballotment test
Patient is supine or long seated position with knees extended
Milk fluid from suprapatellar pouch by stroking superiorly to inferiorly above patella 2-3x
Gently compress pouch by pressing at against femur
Hold that position while tapping the patella against trochlea of femur with index finger of other hand
(+) Sensation that patella is floating
Very little diagnostic value
Test requires more swelling to be present
Knee Passive physiological Motion - Tibial IR/ER
Pt supine, knee flexed to approx 90 deg
Passively internally rotate tibia
Repeat for external rotation
Knee PPM flex/add
flex +heel toward midline/groin
Knee PPM flex/abd
flex + heel toward greater troch
Knee PPM ext/add
ext + heel toward midline
Knee PPM ext/abd
ext + heel toward greater troch
Special Tests for Posterolateral Corner
Reverse Pivot shift - Pt supine, knee flexed 70-80 deg and ER of tibia applied
Knee is passively straightened as examiner applies slight valgus stress at knee
At ~20deg flexion lateral tibial plateau shifts anterior: Positive test
Posterior Drawer with ER - ER tibia and apply posterior force
If normal at 90 but excess at 30 suspect PLC injury
Positive if tibia rotates excessively compared to other side
If rotates and subluxes posteriorly or excess motion at 30 and 90 suspect PCL injury
ER Recurvatum Test - Pt supine in a relaxed position
Pick up pt’s leg by great toe
Watch for hyperextension and tibial ER compared to other side
Prone ER - Pt prone, clinician grasps distal leg, flexes knee and ER tibia
+ if ER exceeds 10 deg of other leg
+ at 30 but not at 90= isolated PLC injury
+ at both = concomitant PCL
Patellafemoral Joint Mobility tests - glide direction/motion
Superior/Inferior
Pt supine, knee in open packed position
Take up slack
Place apex of patella in interthenar eminence
Align forearm with shaft of femur
Apply inferior glide of patella - For FLEXION
Repeat for superior glide - EXTENSION
Medial/Lateral
Pt supine, knee in open packed position
Stand on lateral side of knee
Grasp patella and move in a lateral direction
Repeat for medial glide - FLEXION
Caution with lateral glide (if hypermobile) - for EXTENSION
Tilt Pt supine, knee in open packed position Stand on lateral side of knee Hands wrapped around patella Thumbs used to tilt patella medially and laterally Compare to contralateral side
Tibiofemoral joint distraction
Supine, open packed position, 20 deg flexion
Stabilize distal femur
Distraction force with lumbrical grip along proximal tibia/fibula
Tibiofemoral medial glide of Tibia
*for IR
Pt supine, knee flexed 10-20 deg on bolster
Medial (Tibial IR)
Grasp medial aspect of distal femur and lateral aspect of proximal tibia
Stabilize femur while applying medially directed movement of tibia on femur
Tibiofemoral Lateral glide of tibia
*for ER
Pt supine, knee flexed 10-20 deg on bolster
Lateral (Tibial ER)
Grasp lateral aspect of distal femur and medial aspect of proximal tibia
Stabilize femur while applying laterally directed movement of tibia on femur
PA glide Tibia (tibiofemoral PAM)
*Extension
Pt supine, knee flexed to 60-80 deg of flexion
Grasp around proximal tibia with thumbs on tibial tubercle while sitting on foot to stabilize
Move tibia in anterior direction on femur