Knee Flashcards
1
Q
What type of collagen are ligaments made of?
A
Type 1
2
Q
Grading acute ligament injuries
A
- Grade 1: injury w/o laxity
- Grade 2: partial injury w/ laxity, but some fibers intact
- Grade 3: complete ligament rupture
3
Q
3 phases of ligament healing
A
- Inflammatory phase – bleeding / clot / inflammation
- Proliferative phase – increase in cell density and revascularization of ligament. Fibroblasts in granulation tissue produce disorganized collagen matrix
- Remodeling phase – cellularity decreases and collagen fibers become aligned w/ forces acting on ligament. May last months / years after injury. Immobilization slows remodeling, so movement is important.
4
Q
Typical movement leading to ACL injury
A
Rotational hyperextension
5
Q
What type of injury causes PCL tear?
A
Direct blow to anterior aspect of flexed knee (dashboard, fall). Associated w/ femur fracture.
6
Q
What is the main job of the meniscus?
A
Bear weight
7
Q
What is the meniscus made of?
A
Type 1 collagen
8
Q
Meniscus tear What type of movement causes injury? Hallmark What movement increases pain? Diagnosis Treatment (3)
A
- Often occur w/ twisting injuries in young pxs and may be spontaneous in older pxs.
- Hallmark of meniscal tear is joint line pain / tenderness.
- Deep squatting or twisting often increases the pain.
- H&P allows diagnosis 80% of time. MRI may be needed.
- Treat w/ repair, menisectomy, or observation / PT
- Repair allows for weight-bearing preservation, but can only be done in vascular peripheral third where healing can occur.
- Menisectomy increases joint loads and risk for late DJD.
- PT focuses on increasing ROM and decreasing swelling. Better for older pxs w/ associated knee OA.
9
Q
2 major factors that increase loads across the knee
A
1) Malalignment – varus / valgus may be reinforcing
2) Loss of meniscus
10
Q
Knee OA imaging findings (4)
A
Joint space narrowing, sclerosis, osteophytes, subchondral cysts
11
Q
Treating knee OA
A
- Decrease loads – weight loss, activity modification, correct alignment, brace
- PT – improve motion, strength, and balance
- Surgery
- Arthroscopy for mechanical sxs (beware that 90% have meniscal tears).
- Knee replacement for older pxs
12
Q
Treating patellofemoral pain
A
- Non-operative is 1st line – activity modification, PT, taping, bracing, orthotics
- Surgery is rare and used for dislocations (rather than pain)
13
Q
Patellar tendonitis characteristics
A
Common w/ aging.
Should be called tendonosis b/c no swelling.
