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OCS > Knee > Flashcards

Knee Flashcards

1
Q

Overweight, very tall, and thin prepubescents males (8-17 y/o) w/ ant thigh and/or knee pain - negative examination (Dx?)

A

Slipped Capital Femoral Epiphysis

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2
Q

identifying slipped capital femoral epiphysis

A

FABER test - flexion, abduction, ER of hip with overpressure

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3
Q

Legg Calve Perthes syndrome

  • age demographic
  • pain location (most often)
  • presentation, onset, and mobility
A
  • 5-12 y/o
  • anterior thigh and possibly knee
  • knee swelling, gradual onset, with locking
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4
Q

PFP provocative tests (6 total)

A
  1. pain w/ manual compression of PFJ
  2. pain w/ palpation of posteromedial and posterolateral patellar borders
  3. pain w/ resisted isometric quadriceps femoris contraction
  4. pain w/ squatting
  5. pain during kneeling
  6. pain during prolonged sitting
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5
Q

Four biological phases of cartilage maturation

A

proliferation, transitional, remodeling, and maturation

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6
Q

Motions to avoid following meniscal injury (4)

A

squatting, pivoting, cutting, and running

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7
Q

Squatting angles permitted for meniscal repair at 4 and 8 weeks post-op

A

<45 deg and <90 deg (respectively); >90 deg permitted after week 8

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8
Q

Two most important things for most knee surgery rehabs

A

Obtaining terminal knee extension and quadriceps strengthening

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9
Q

Hyaluronic acid

A

Shock absorber and lubricant in synovial fluid - directly injected

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10
Q

Posterolateral corner is comprised of…

A

arcuate ligament
LCL
popliteal tendon
lateral head of the gastrocnemius

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11
Q

Five measures - Meniscal Pathology Composite Score

ALSO THE CPR FOR THE KNEE (John Snyder, DPT site)

A
  1. history of catching/locking
  2. joint line tenderness
  3. pain with forced hyperextension
  4. pain with max knee passive flexion
  5. pain or an audible click with the McMurray test
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12
Q

Step down test - how do you do it?

A

step down with measuring painful angle

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13
Q

Sage sign

A

greater than 50% of patellar width displacement (25-50% of patellar width change is normal)

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14
Q

Patellar tilt test - knee positioning

A

Completed in 20 deg of knee flexion

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15
Q

Cluster testing for patellofemoral pain

A

positive reproduction of pain with isometric quadriceps muscle contraction and/or pain during squatting and/or pain during palpation (PL and PM borders)

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16
Q

Important functional knee tests - walking for elderly and pt’s with OA (4)

A
  1. Timed Stair-climbing test
  2. Six-minute walk test
  3. Timed Up and Go test (TUG)
  4. Five time sit to stand
17
Q

Four phase of rehabilitation following osteochondral autograft transplantation (OATS) and autologous chondrocyte implantation (ACI) procedures

A
  1. Proliferation phase (0-6 weeks)
  2. Transition phase (6-12 weeks)
  3. Remodeling phase (12-26 weeks)
  4. Maturation phase (26-52 weeks)
18
Q

Distal Patellar Realignment Surgeries (3)

A
  1. Fulkerson Osteotomy
  2. Hauser
  3. Elmslie Trillat
19
Q

Posterolateral drawer test - positive finding

A

Posterolateral rotation of tibia when NEGATIVE; when POSITIVE, tibia rotates posterolaterally and posteriorly subluxes

20
Q

Prone external rotation test

  1. tests what?
  2. position and testing?
  3. positive findings indications?
A
  1. posterolateral (PL) corner of the knee
  2. prone position with B knees flexed 30 deg; both lower limbs ER
  3. greater than 10 deg difference of ER on affected side may indicate PL corner injury
21
Q

Lachman’s test

  1. tests what?
  2. position and testing?
  3. findings?
A
  1. ACL
  2. 30 deg knee flexion with anterior tibial translation
  3. Empty end-feel with testing is positive
22
Q

Step-down test

A

record the angle of flexion achieved along with subjective pain report (VAS or VRS) during descent.

23
Q

Noyes Hop Test

  • purpose
  • how completed
  • describe the four variants (cluster)(4)
A

Commonly used functional test for return to sports.

  • involve hopping distance and time to that of uninvolved limb
  • tests are: single hope for distance, triple hop for distance, crossover triple hop for distance, and a timed 6 m. hop
24
Q

Non-surgical ACL screen

  1. Episodes of giving a way
  2. Noye’s hop test
  3. KOS ADLs
  4. Global rating score
A
  1. 1 or less since injury
  2. > 80%
  3. > 80%
  4. > 60%
25
Q

Level 1 sports vs Level 2 sports

A
  1. Level 1 encompasses jumping, cutting, and pivoting types of maneuvers for 50 hours or more per year
  2. Level 2 are those that involve lateral movement (e.g. racquet ball and skiing)
26
Q

PCL - ranges restricting posterior tibia translation

  1. Anterolateral - purpose
  2. Posteromedial - purpose
A

PCL restricts 95% of posterior displacement of tibia on femur between 30-90 deg.

  1. AL bundle bears 50-74% of the posterior force between 40-120 deg.
  2. PM responsible for 57% of posterior force beyond 120 deg.
27
Q

Measures when determining a successful ACL rehab outcome:

A
  1. less than mild persistent perfusion
  2. > 90% quad and hamstring muscle strength
  3. absence of giving way episodes
  4. participation in 1 or 2 seasons of sports
  5. patient-reported outcomes
28
Q

Anterior drawer
+ translation with tibial ER? if so what is wrong?
+ translation with tibial IR? if so what is wrong?

A

Anterior drawer: positive with 6 mm change with translation with soft end-feel
Increased excursion with tibial ER may indicate anteromedial instability (MCL, med capsule, post. oblique ligament)
Increased exc. with tibial IR –> possible anterolateral instability

29
Q

Ideal testing position of LCL and MCL (pure test)

A

20-30 deg knee flexion

30
Q

Full knee extension varus and valgus tests what structures

A

Varus: LCL, ACL, and PCL
Valgus: MCL, ACL, and PCL

31
Q

What may happen that could interfere with testing using the pivot shift test?

A

Pt’s will tend to guard, anticipating a shift or pain.

32
Q

Level B evidence of what regarding ACL bracing immediately post-operative - to use or not to use?

A

Not using a brace

33
Q

Cryotherapy (per CPG) for ACL rehab has what level evidence

A

Level C evidence

34
Q

MCL pathology CPR

A

Rotational trauma
Trauma by external force to the leg
Pain with valgus stress test at 30 deg flexion
Laxity with valgus stress test at 30 deg flexion

35
Q
  1. Pittsburgh (CPR) knee rules

2. what is this used for?

A
  1. Blunt trauma or fall as mechanism of injury plus…
    - >50 y/o or <12 y/o
    * and/or*
    - inability to walk 4 steps WB steps in the emergency dept.
  2. identify need for radiographs of the knee

OCS (8 decks)

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