Knee Flashcards
Suscpect a patella fracture. What views must you get not to miss peripherial fractures.
Latreral- horizontal Sunrise- vertical
Nonsurgical managment of patella fracture
Start splinting in extension with gradual flexion
The most common area of a Tibial plateau fracture
Lateral
Absolute indications for surgery for tibial plateau fracture
open fracture, compartment syndrome
Nonoperative managment for tibial plateau fracture
NWB for 6 weeks.
Often an associated injury seen with ACl and medial meniscus injury
Segond’s Fx- capsular avulsion of the lateral tibial plateau.
2 high risk stress fractures of the knee.
Patella and Medial tibial plateau
A young female likely to present with (traumatic or nontraumatic ) patella dislocation
nontraumatic
What presentation of patella dislocation with would point to a traumatic type
hemarthrosis
What would the lateral apprehension test be used for?
Patella dislocation - apprehension when moving the the patella laterally
What imaging is needed following a patella dislocation that has relocated.
XRAY- ostechondral fracture or avulsion. MRI if symptoms persist, concern for osteochondral defet or multiple dislocations.
Type of knee dislocation from a hyperextension injury
Anterior ( tibia relative to femur)
Type of knee dislocation form a dashboard injury
Posterior
Knee dislocation usually associated with what neurovascular injuries?
Nerve- fibular Artery- popliteal
2 Test to aid in ITB Friction syndrome
Noble’s Test Obers Test
A runner with lateral knee pain while running but goes away at rest.
ITB Frictions syndrome
Runner with lateral knee pain. Where would tenderness be located on physical exam if you think ITB Friction Syndrome.
3cm proximal to lateral joint (over the lateral femoral condyle)
Patellar fracture is usually seen in what demographic?
older female with osteoporosis
Quad Tendon tear is usually seen in what demographic?
Male older then 60
Patella tendon rupture is usually seen in what demographic?
Younger male around 40s
Terrible Triad
ACL, Medial Meniscus, MCL
What is the grade ACL tear for a positive Lachman 0-5mm
Grade 1
What is this called?
Kissing contusion
ACL tear
RTP following ACl surgery
6- 9 months
PCL injury typically occurs by what mechanism
anterior tibia with knee flexion hits dashboard.
Test used for PCL tears
POSITIVE QUAD ACTIVATION
REVERSE LACHMANS
POSTERIOR SAG
Gold standard diagnosis for PCL
arthoscopy
What muscle group needs to be strengthing in order to rehab a PCL injury?
quad strengthing in order to prevent posterior tibial translation
IDENTIFY
PELLEGRINI-STIEDA SIGN
MCL TEAR
WHAT IS THE ONLY REASON AN ISOLATED MCL TEAR WOULD REQUIRE SURGERY?
TIBIAL SIDED AVULSION
EXPLAIN REHAB FOR MCL
ACUTE PHASE- RICE
HINGED KNEE BRACE
1-2 WEEKS EARLY ROM AND ADVANCE WITH MORE 4 WEEKS
DIAL TEST :
AT 30 DEGRESS OF KNEE FLEXION INCREASED EXTERAL ROTATON BUT NOT AT 90
ISOLATED PLC INJURY
DIAL TEST :
AT 30 DEGRESS OF KNEE FLEXION INCREASED EXTERAL ROTATON WITH THE SAME AT 90
PCL AND PLC
MOST COMMON PLICA IS MEDIAL OR LATERAL
MEDIAL
Most commonly irriated from abrading medial femoral condyle
Anterior inferior knee pain worse with sitting to standing
Hoffas fat pad impingement
Symptoms to help distinguish Hoffa’s Fat Pad vs. MPF syndrome
MPFL- sitting
Hoffa- sitting to standing
What is chondromalacia patella?
Degeneration of patella cartalige from patellofemoral syndrome
What is MOI for lateral meniscus injury
Occurance after knee flexion. Squating wrestling
Which part of the meniscus has poor blood supply?
Inner 2/3
A Q ANGLE OF > ___ DEGREES IN PATELLOFEMORAL SYNDROME
20
ASIS—> MID PATELLA
MID PATELLA—> TIBIAL TUBERCLE
PATELLAFEMORAL SYNDROME CAN BE A RESULT OF WEAK ___
Hamstrings
