knee

Question 1

is genu varum bow legged or knock kneed?

Answer 1

bow legged

Question 2

what occurs at the posterolateral corner of the meniscus?

Answer 2

it is separated from the rest of the capsule by the popliteus tendon

Question 3

which meniscus, lateral or medial, is more commonly injured?

Answer 3

medial

Question 4

what two motions does the LCL restrain?

Answer 4

varus, lateral tibial rotation

Question 5

when is the LCL most responsible for restraint of lateral gapping and why?

Answer 5

at 25 degrees of knee flexion, all posterior structures are on slack

Question 6

when is the MCL most responsible for restraint of medial gapping and why?

Answer 6

at 25 degrees of knee flexion, open pack of the knee, other structures are on slack

Question 7

why is the MCL able to heal easily?

Answer 7

rich blood supply

Question 8

what forces does the posterolateral bundle of the ACL resist and during what degrees of knee flexion?

Answer 8

anterior at 0-20 degrees of knee flexion

Question 9

what forces does the anteromedial bundle of the ACL resist and during what degrees of knee flexion?

Answer 9

anterior at 20-90 degrees of knee flexion

Question 10

what is the most common cause of noncontact ACL injuries

Answer 10

deceleration with the knee in slight flexion coupled with medial or lateral tibial rotation

Question 11

how many parts does the PCL have and what are they?

Answer 11

2, anterolateral and posteromedial

Question 12

what part of the PCL is the most important and when is it tight?

Answer 12

anterolateral, tight in flexion

Question 13

what two ligaments oppose medial forces?

Answer 13

PCL and MCL

Question 14

can you selectively activate the VMO?

Answer 14

no it is innervated by the femoral nerve along with the rest of the quads so it is quite difficult to isolate

Question 15

what is the difference in anterior shear forces at the knee during OKC vs CKC exercises.

Answer 15

OKC has high shear forces while CKC has low shear forces

Question 16

what is a normal Q-angle for men?

Answer 16

10-15 degrees

Question 17

what is a normal Q-angle for women?

Answer 17

15-20 degrees

Question 18

what are the ottowa knee rules?

Answer 18

age >55, isolated tenderness of the patella, fibular head tenderness, inability to flex knee to 90 degrees, inability to bear weight after injury and in ER (need 4 steps)

Question 19

what diff dx should you be aware of in someone who is between 8-17 years old, reproduced knee pain with a FABER test, loss of hip IR, and increased hip ER?

Answer 19

SCFE - Slipped capital femoral epiphysis

Question 20

what population is the WOMAC used for? what score indicated a healthy knee?

Answer 20

OA of the knee, 0 is a healthy knee score

Question 21

What population is the KOOS useful on? what score indicated a healthy knee?

Answer 21

higher activity folks, 100 is a healthy knee

Question 22

what population is the IKDC-SF useful for?

Answer 22

everyone, broad population

Question 23

what population is the Lysholm Knee Score useful for? What score indicated a healthy knee

Answer 23

after ligamentous and meniscal surgery, 100 is a healthy knee

Question 24

What population is the KOS useful with? What score indicates a healthy knee?

Answer 24

useful with a broad audience, a higher score is a healthier knee

Question 25

what population is the LEFs useful for and what score indicates a healthy knee?

Answer 25

broad audience, higher score is a healthier knee

Question 26

on the fear avoidance beliefs questionnaire what does a higher score indicate?

Answer 26

higher fear avoidance

Question 27

if someone has >5mm gapping on the valgus stress test, what other structures may be involved?

Answer 27

usually PCL and possibly ACL

Question 28

how would you grade the sensitivity and specificity of the anterior drawer test on acute ACL injuries?

Answer 28

poor

Question 29

how would you grade the sensitivity and specificity of the anterior drawer test on chronic ACL injuries?

Answer 29

pretty darn good

Question 30

how can you use the posterior drawer test to dx a PL corner injury?

Answer 30

perform the test at 30 and 90 degrees of flexion, a positive test with have excessive posterior translation at 30 degrees of flexion

Question 31

if someone has excessive posterior translation at 30 degrees but not at 90 degrees on the posterolateral drawer test what does that indicate?

Answer 31

a Posterolateral corner injury

Question 32

how do you perform the prone external rotation test (dial test)

Answer 32

patient in prone, test tibial ER at 30 and 90 degrees of flexion

Question 33

what is a positive test on the prone ER test (dial test)?

Answer 33

>10 degrees of external rotation on the involved side

Question 34

what if someone has >10 degrees of rotation on the dial test at 30 and 90 degrees of flexion?

Answer 34

possible PCL and posterolateral corner involvement

Question 35

what three tests are used for meniscus?

Answer 35

mcmurray, apleys, joint line tenderness

Question 36

what is a useful cluster for meniscus tears? (5 items)

Answer 36

hx of catching or locking, joint line tenderness, pain with forced hyperextension, pain with max knee passive knee flexion, pain or clicking with McMurrays

Question 37

what percentage is considered normal in hop performance side to side?

Answer 37

80-85%

Question 38

what knee dx have shown a positive response to taping?

Answer 38

PFP and OA

Question 39

has bracing been shown to be beneficial in ACL patients?

Answer 39

no

Question 40

what 4 criteria must someone meet to be eligible for conservative management of an ACL tear?

Answer 40

no more than 1 episode of giving way since injury, greater than 80% on the hop test, KOS ADL score >80%, and global rating score >60%

Question 41

if an ACL and PCL are recon at the same time, which protocol do you follow?

Answer 41

PCL, the outcomes are worse and failure rates are higher

Question 42

in a pt who is not skeletally mature what is normally done with an ACL rupture in terms of surgery and timing?

Answer 42

wait until the epiphyseal plates are closed

Question 43

do most PCL injuries require surgery?

Answer 43

no

Question 44

how long is RTP typically after a grade III PCL injury?

Answer 44

3 months

Question 45

how long is RTP typically after a grade I and II PCL injury?

Answer 45

2-4 weeks

Question 46

what are two things you have to be very cautious about after PCL surgery?

Answer 46

no flexion past 70 degrees initially as it stretches repair, no resisted knee flexion for 8 weeks as it causes posterior tibial translation

Question 47

what will someone with a posterolateral corner injury complain of?

Answer 47

instability with cutting and pivoting

Question 48

what exercises should be avoided after posterolateral corner recon and for how long?

Answer 48

isolated hamstring exercises, for 4 months due to posterior pull and translation

Question 49

when is meniscal transplant contraindicated?

Answer 49

when a pt has varus or valgus malalignments, advanced OA, uncontrolled knee instability

Question 50

what is the timeline to run after a meniscus transplant?

Answer 50

1 year

Question 51

what is the long term outcome of mensicus transplant?

Answer 51

usually deterioration and further surgery

Question 52

what is the strongest predictor of functional limitations in patients with knee OA?

Answer 52

quad weakness

Question 53

are unloading braces useful in unicompartmental OA?

Answer 53

yes

Question 54

after an osteotomy how long is weight bearing and resistance limited for?

Answer 54

4 weeks

Question 55

how soon after a debridement or chondroplast can someone return to sport?

Answer 55

as early as 4 weeks

Question 56

how soon after micro fracture can someone return to sport (both small and large)

Answer 56

4-6 months for small lesion, up to 8 months for large lesions

Question 57

has patellar taping been shown to be helpful in treating PFP?

Answer 57

yes

Question 58

does the direction of taping matter in PFP?

Answer 58

only kind of, tape in the direction of relief, not what you see anatomically

Question 59

what is the site of irritation with Osgood-Schlatter disease?

Answer 59

tibial tubercle

Question 60

what age do you normally see OSD occur?

Answer 60

10-15 y/o

Question 61

what is the site or irritation with Sending -Larson-Johansson disease?

Answer 61

inferior pole of the patella

Question 62

what age range do you normally see SLJ symptoms?

Answer 62

10-12 y/o