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OCS > knee > Flashcards

knee Flashcards

1
Q

is genu varum bow legged or knock kneed?

A

bow legged

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2
Q

what occurs at the posterolateral corner of the meniscus?

A

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

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3
Q

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

A

medial

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4
Q

what two motions does the LCL restrain?

A

varus, lateral tibial rotation

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5
Q

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

A

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

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6
Q

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

A

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

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7
Q

why is the MCL able to heal easily?

A

rich blood supply

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8
Q

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

A

anterior at 0-20 degrees of knee flexion

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9
Q

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

A

anterior at 20-90 degrees of knee flexion

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10
Q

what is the most common cause of noncontact ACL injuries

A

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

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11
Q

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

A

2, anterolateral and posteromedial

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12
Q

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

A

anterolateral, tight in flexion

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13
Q

what two ligaments oppose medial forces?

A

PCL and MCL

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14
Q

can you selectively activate the VMO?

A

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

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15
Q

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

A

OKC has high shear forces while CKC has low shear forces

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16
Q

what is a normal Q-angle for men?

A

10-15 degrees

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17
Q

what is a normal Q-angle for women?

A

15-20 degrees

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18
Q

what are the ottowa knee rules?

A

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)

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19
Q

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?

A

SCFE - Slipped capital femoral epiphysis

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20
Q

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

A

OA of the knee, 0 is a healthy knee score

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21
Q

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

A

higher activity folks, 100 is a healthy knee

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22
Q

what population is the IKDC-SF useful for?

A

everyone, broad population

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23
Q

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

A

after ligamentous and meniscal surgery, 100 is a healthy knee

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24
Q

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

A

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

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25
Q

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

A

broad audience, higher score is a healthier knee

26
Q

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

A

higher fear avoidance

27
Q

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

A

usually PCL and possibly ACL

28
Q

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

A

poor

29
Q

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

A

pretty darn good

30
Q

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

A

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

31
Q

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

A

a Posterolateral corner injury

32
Q

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

A

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

33
Q

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

A

> 10 degrees of external rotation on the involved side

34
Q

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

A

possible PCL and posterolateral corner involvement

35
Q

what three tests are used for meniscus?

A

mcmurray, apleys, joint line tenderness

36
Q

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

A

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

37
Q

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

A

80-85%

38
Q

what knee dx have shown a positive response to taping?

A

PFP and OA

39
Q

has bracing been shown to be beneficial in ACL patients?

A

no

40
Q

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

A

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%

41
Q

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

A

PCL, the outcomes are worse and failure rates are higher

42
Q

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

A

wait until the epiphyseal plates are closed

43
Q

do most PCL injuries require surgery?

A

no

44
Q

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

A

3 months

45
Q

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

A

2-4 weeks

46
Q

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

A

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

47
Q

what will someone with a posterolateral corner injury complain of?

A

instability with cutting and pivoting

48
Q

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

A

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

49
Q

when is meniscal transplant contraindicated?

A

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

50
Q

what is the timeline to run after a meniscus transplant?

A

1 year

51
Q

what is the long term outcome of mensicus transplant?

A

usually deterioration and further surgery

52
Q

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

A

quad weakness

53
Q

are unloading braces useful in unicompartmental OA?

A

yes

54
Q

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

A

4 weeks

55
Q

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

A

as early as 4 weeks

56
Q

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

A

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

57
Q

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

A

yes

58
Q

does the direction of taping matter in PFP?

A

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

59
Q

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

A

tibial tubercle

60
Q

what age do you normally see OSD occur?

A

10-15 y/o

61
Q

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

A

inferior pole of the patella

62
Q

what age range do you normally see SLJ symptoms?

A

10-12 y/o

OCS (12 decks)

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