knee Flashcards
when is L/S manip appropriate for PFJ pain?
diff in hip IR >14 deg, ankle DF with knee flexed >16 deg, navicular drop >3 mm, no stiffness with sitting 20 min, squatting is most painful activity
clinical findings that would support use of orthotics for PFP syndrome
2 deg or more forefoot varus, 78 deg or less great toe ext
clinical findings to support use of patellar taping for PFP
tibial angulation >5 deg, (+) patellar tilt test
tests useful for meniscal dx
mcmurray, joint line tenderness, thessaly
tests for ruling in/ruling out ACL tears
ruling in: ant drawer and pivot shift
ruling out: lachman
best test for patellar instability
moving patellar apprehension test
ottowa knee rules
> 55 yo, tenderness at head of fibula or patella, inability to flex knee to 90 deg, inability to WB immediately and upon ER arrival
area of ACL impingement
intercondlyar fossa
what rotation of the tibia is needed for full extension?
lateral
describe grade I-IV joint mobs
I: small amp, pain relief
II: large amp, pain relief
III: large amp, capsule stretch
IV: small amp, capsule stretch
be cautious with what after PCL reconstruction?
flexion; the graft is tensioned between 70 and 90 - no ham curls for 4 months post-op
a degenerative process is characterized by….
fibroblasts, vascular hyperplasia and disorganized collagen
what is the quad index and why is it cool?
quad index is strength of involved quad/strength of uninvolved quad - if less than 85%, was indicative of decreased function. Was better at predicting hop test performance than other factors, including: graft type, presence of meniscus injury, knee pain and knee sx
which meniscus is C-shaped and which one is O-shaped?
O shaped: lateral
C shaped: medial
which ligs hold the menisci in place?
coronary ligaments
what is contained in the arcuate complex?
LCL (or FCL), arcuate lig, popliteus tendon and biceps femoris tendon
which menisci has a better chance of healing after injury?
medial (rich blood supply)
what type of shear force is created during squat/leg press?
posterior shear (greatest between 83-105 deg); no anterior shear
when is anterior shear developed during okc quad exercise?
40 deg til 10 deg ext
what are the criteria for pertubation testing after ACL tear?
< or = to 1 episode of giving way, >or= to 80% timed on hop tests, >or= to 80% on KOS - ADL score, >or= to 60% on global rating score
what precautions need to be followed if patellar tendon graft is used for ACL repair? hamstring graft?
patellar: possible irritation during PRE’s, consider alteration of knee flexion angle during NMES (45-60 deg)
hamstring: no ham strengthening until 8-12 wks post-op
what precautions need to be followed if partial menisectomy is done with an ACL? meniscal repair?
menisectomy: no specific modifications
meniscal repair: no WB flexion beyond 45 deg for 4 wks
what precautions need to be followed if MCL injury occurred along with ACL-R
restrict motion to sagittal plane until 4-6 wks for MCL healing, perform PREs with tibia in IR during early postop period
