Knee Flashcards

1
Q

Examples of Knee Pathology

A
  • PFPS
  • Patellar Tendinopathy
  • ITB Syndrome
  • Knee OA
  • ACL
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2
Q

PFPS

A
  • patellofemoral pain syndrome
  • most common complaint in runners
  • repetitive overload
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3
Q

PFPS Influences

A
  • local (mal-tracking)
  • proximal
  • distal
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4
Q

PFPS: Local Influence

A
  • mal patellar tracking
  • patellar tilt that compresses lateral patella
  • delayed activation of VMO
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5
Q

PFPS Treatment

Local

A
  • VMO/biofeedback
  • Straight leg raising-hip adductors (leg in ER)
  • limited squatting–>full squat
  • patellar taping (short term)
  • stretch IT band
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6
Q

Normal Patellar Tracking

A
  • with knee in flexion patella is lateral
  • as knee extends patella tracks medial then laterally
  • should not tilt
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7
Q

PFPS:

Proximal Influence

A
  • hip affects knee
  • dynamic Q-Angle
  • weak abd/ER Mm allowing femur to IR and increase Q-angle–>more stress on patella
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8
Q

PFPS:

Distal Influence

A

-Overpronation of the foot causes tibial/femur IR and knee valgus–>increased stress on patella

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9
Q

Foot Orthotics with PFPS

A

-has some research to support decreased pain

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10
Q

Tendinitis

A
  • inflmmatory
  • warm to touch
  • Ice, NSAIDs
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11
Q

Tendinosis

A
  • Collagen degeneration
  • chronic
  • exercise, (eccentrics)
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12
Q

Mechanism of patellar tendinopathy

A
  • weak quads

- overuse of tendon (dominant quads, glut max weak)

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13
Q

Quad dominant

A

-in squat knees go way past feet

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14
Q

Glut max dominant

A

-in squat, sit back with knees behind toes

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15
Q

Work quad more on:

A

-down sloped wedge

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16
Q

work glut max more on:

A

-flat surface

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17
Q

Plyometrics:

A
  • forward hops
  • bounding
  • step hops
18
Q

cho-pat strap

A
  • brace for knee (PFPS)

- decrease tendon strain

19
Q

ITB Syndrome

A
  • Iliotibial band syndrome
  • pain 1-2” above joint line, lateral side
  • 2nd cause of knee pain
20
Q

Nobles Compression Test

A

-ITB Syndrome test

21
Q

Function of ITB

A

-decelerate IR or tibia

22
Q

Insertion of ITB

A
  • patella
  • Gerdy’s tubercle
  • Fibular head
23
Q

Impingement Zone

A
  • 20-30* flexion

- ITB more taut and causes pain on fat pad under ITB

24
Q

Biomechanical factors of ITB Syndrome

A
  • prominent LFC (lateral femoral condyle)
  • weak hip abductors
  • ITB tightness
  • Genu varum
25
Q

Treatment for ITB Syndrome

A
  • strengthen (glud med, hip ER)
  • joint mob (sup tib-fib)
  • Foam Roller
  • cho-pat bracing
  • Surgery: cut ITB and shave down lateral epicondyle
26
Q

ITB Syndrome & Running

A
  • avoid running down hill

- avoid banked surface (valgus knee)

27
Q

Diagnosing OA

A
  • knee pain plus 3 of following:
  • -age>50
  • -AM stiffness <30 min
  • -Crepitus
  • -bony tenderness
  • -no palpable warmth
  • -osteophytes on x-ray
28
Q

Risk Factors of OA

A
  • age
  • female
  • obesity
  • previous injury (ACL, Meniscus)
  • Mm Weakness
29
Q

Stage I for OA Rehab

A
  • joint mobs (distraction, ant/pos, rotational)
  • strengthen around knee
  • weight reduction
  • canes, unloader braces, orthotic wedging
30
Q

TKA Rehab

A
  • Quad strengthening
  • Eccentric Stepper
  • NMES with Quad Ex’s
31
Q

Eccentric Stepper

A
  • 5-20 min sessions
  • 4 weeks
  • increase intensity over 12weeks
32
Q

NMES Quads

A
  • 2-3 weeks post surgery
  • 3x/week
  • 6 weeks
  • open and closed chain
33
Q

ACL Prevention:

3 Phases

A
  • Technique Development
  • Fundamental
  • Performance
34
Q

ACL Prevention Program

A
  • 15-25 min warm up routine
  • 3x/week
  • warm up, stretch, strengthen, plyometrics, agility
35
Q

Stage II Knee OA Rehab

A

Hip strengthening

36
Q

Stage III Knee OA Rehab

A

Aerobic Exercise

37
Q

Treatment of Knee OA

A
  • manual therapy
  • open vs closed chain ex’s
  • weight loss
  • AD (cane, unloader brace, orthotic wedging)
  • cycling
  • aquatics
38
Q

Medical Management of Knee OA

A

-total joint arthroplasty (TKA)

39
Q

UCA

A
  • unicompartmental arthroplasty

- only replace the side that you need

40
Q

Activities Allowed After TKA

A
  • low impact aerobics
  • stationary cycling
  • bowling
  • golf
  • dancing
  • horseback riding
  • swimming
  • walking
41
Q

Activities Allowed if You’ve Done them before (after TKA)

A
  • road cycling
  • canoeing
  • hiking
  • rowing
  • cross-country skiing
  • nordic track skiing
  • speed walking
  • tennis
  • ice skating
42
Q

Activities Not Recommended after TKA

A
  • racquetball/squash/handball
  • soccer
  • single tennis
  • volleyball
  • basketball
  • jogging