Knee

Question 1

Two categories of meniscal injuries

Answer 1

1. Acute tear
2. Degenerative tear

Question 2

Acute tear

Answer 2

1.usually occurs when the knee is flexed and forcefully twisted

Question 3

Degenerative tear

Answer 3

more common in geriatrics. 60% of age group >65 will have some degenerative tear of the meniscus

Question 4

T/F Degenerative tears may occur from minor event and have symptoms

Answer 4

False
May have no symptoms

Question 5

DJD

Answer 5

asymmetrical loss of joint space, subchondral sclerosis, osteophyte formation

Question 6

The medial meniscus

Answer 6

is more commonly injured because it is firmly attached to the medial collateral ligament and joint capsule.

Question 7

lateral meniscus

Answer 7

•more mobile because it does NOT attach to the lateral collateral ligament or the joint capsule and, consequently, is injured less frequently.

Question 8

MENISCUS Blood flows

Answer 8

•only to the outer edges of the meniscus (about 1/3)

healing difficult

•tears in the outer 1/3 have the best chance of healing

Question 9

MENISCUS STABLE

Answer 9

•stable tear does not move and heals on its own or with conservative care

Question 10

MENISCUS UNSTABLE

Answer 10

•an unstable tear moves abnormally and is likely to need surgical repair

Question 11

MENISCUS men vs women

Answer 11

•Men are 20% more likely to sustain a meniscal injury than women

Question 12

Apley Compression Test

Answer 12

Positive: Patient points to side of pain.

Indicates: Pain on medial side is medial meniscus tear. Pain on the lateral side indicates lateral meniscus tear.

Question 13

Apley’s Distraction Test

Answer 13

Positive: Patient will point to side of pain.

Indicates: Pain on the medial side indicates medial collateral ligament tear. Pain on the lateral side indicates lateral collateral ligament tear.

Question 14

McMurray Sign

Answer 14

Positive: Clicking sound or pain by knee joint.

Indicates: Tear of medial meniscus if positive on external rotation
Tear of lateral meniscus if positive on internal rotation
The greater the angle the knee is flexed when the positive is elicited, the more posterior the meniscal injury.

Question 15

Test for Meniscus

Answer 15

Apley’s Compression Test

Apley’s Distraction Test

McMurray’s Test

Question 16

ACL stats

Answer 16

•About ½ of all ACL injuries occur along with injury to cartilage, meniscus and/or other ligaments

Question 17

ACL •GRADING SPRAINS AND STRAINS:

Answer 17

• GRADE I: FIBERS ARE STRETCHED
• GRADE II: SOME FIBERS TORN
• GRADE III: AVULSION

Question 18

ACL injuries

Answer 18

• GRADE I AND II ARE RARE (of ACL)
• MOST ACL INJURIES ARE COMPLETE TEARS (GRADE III)

Question 19

•Causes of ACL injuries:

Answer 19

• Quick change in direction
• Sudden stopping
• Slowing down while running
• Landing incorrectly from a jump
• Direct collision (like football tackle)

Question 20

ACL •SYMPTOMS/Pt PRESENTATION OF ACL INJURY:

Answer 20

• Pain/swelling within 24 hours
• ↓ ROM
• Tenderness along joint line
• Discomfort while walking

Question 21

EXAMINATION for SUSPECTED ACL TEAR

Answer 21

Lachman’s T. **** (THIS IS THE GOLD STANDARD FOR ACL

Question 22

BOUNCE HOME T.

Answer 22

Positive: knee does not go into full extension

Indicates: diffuse swelling of the knee accumulation of fluid due to possible meniscus tear

Question 23

Lachman Test

Answer 23

Positive: Gapping with the tibia moving away from the femur.

Indicates: ACL or posterior oblique ligament instability

Question 24

three test for ACL

Answer 24

1. BOUNCE HOME T.
2. DRAWER T.
3. LACHMAN’S T.

Question 25

ACL •Chiropractic Management if non-surgical case:

Answer 25

• Adjust spine
• Reduce swelling (RICE)
• AFTER SWELLING IS REDUCED:
• Adjust knee if indicated
• Brace knee
• Tape knee
• Reduce inflammation
• Exercises to restore strength

Question 26

ACL high school tears

Answer 26

1. Football
2. Boy’ soccer
3. Girl’s soccer