Knee Exam Flashcards
Knee Injury & OA Outcome Score (KOOS)
Short & long time intervals to assess treatment over the years for knee injury or OA
0= extreme problems
100= no problems
ACL QoL
Best for patients following ACL injury/repair
0-100 (higher score, better)
ACL Return to Sport
Best for patients following ACL injury/repair near end of rehab, considering return to sport
0-100 (higher score, better)
LE alignment Genu Valgum
Possible causes: Coxa Vara &/or Excessive foot pronation
Gapping at Medial Aspect of knee
Compression at Lateral Aspect
Stretches MCL
LE alignment Genu Varum
Most commonly seen with KOA
Compression at Medial Aspect of knee
Gapping at Lateral Aspect of knee
Consequence: may affect LCL, PCL
Screen Hip and Ankle first
Hip: FADIR (99% sensitivity), and FABER
Ankle: AROM w/ OP (PF, DF, Inversion, Eversion)
Ottawa Knee Decision Rule
(to refer for radiograph)
- age 55 y.o or older
- isolated tenderness of patella
- tenderness of head of fibula
- inability to flex to 90 deg
- inability to bear weight both immediately & in ER
Pittsburg Knee Decision Rule
(to refer for radiograph)
- fall or blunt trauma MOI
- age < 12 or age > 50
- inability to walk 4 weight-bearing steps in ER
Well’s Criteria for Deep Vein Thrombosis (DVT)
Following a period of bedrest/immobilization/surgery/trauma patient experiences:
-swelling in back of calf
-superficial collateral veins
-edema in back of calf
-active cancer
What is the most important knee ROM for normal gait
Knee Extension!!!!
Physical Performance Measures:
General Population
6 MWT
TUG
30 sec STS
SLS
Step Test
BERG
Physical Performance Measures:
Athletic Population
Star Excursion
Single Leg squat
Double Leg squat
Physical Performance Measures:
Return to Sport
30 second single leg squat
Star excursion
Standing long jump
Single Leg press
Isokinetic Testing
Functional Hop test
Step Test
For KOA, # of steps completed in 15 seconds. Stands on limb with KOA. Quantifies balance & neuromuscular control
KOA avg = 12
30 Second Squat Test
perform max # of squats to 70 deg knee flexion as possible in 30 sec. quantifies strength & neuromuscular control. 15 = nonathletic pop, 20 = athletic pop
single leg press
9 months post-op
symmetrical between legs or at least 90% symmetrical
Special Tests for Meniscal Pathology
McMurray’s
Apley’s
Thessaly Test
Bounce Home Test
Clinical Predication Rule for Meniscal Pathology
-history of catching/locking reported by patient
-joint line tenderness
-Pain w/ forced hyperextension (bounce home)
-Pain w/ max knee flexion
-pain or audible click w/ McMurray
Special Tests for ACL Tears
Lachmans
Anterior Drawer
Pivot-Shift
Special Tests for PCL Tears
Posterior Drawer
Posterior Sag Sign/Godfrey’s
Active Drawer Test
Special Test for MCL Tears
Valgus Stress Test
Palpation of MCL
Special Tests for LCL Tears
Varus Stress Test
Palpation of LCL
Dial Test
Asymmetry at 30 = Posterolateral Corner
Assym at 90 = Posterior Collateral Ligament
Assym at 30 & 90 = Both
Patellofemoral Pain Syndrome Tests
-Pain during Functional Activities(squatting, stair climbing, kneeling)
-Resisted Knee Extension
-Eccentric Step Down
Cluster Testing (Pain w/ resisted Knee Ext AND Pain w/ squatting)
(+) = reporting pain during one of activities
