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MSK LQ > Knee Exam, Eval, & Interventions > Flashcards

Knee Exam, Eval, & Interventions Flashcards

1
Q

special tests for ACL tear

A

Lachman’s
anterior drawer
pivot shift

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2
Q

<___% of uninvolved side is a positive finding on the 6 m hop test

A

80%

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3
Q

what is a segond fracture?

A

avulsion of LCL from excessive tibial IR
(indirect sign of ACL tear)

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4
Q

where is bone bruising most common in knee?

A

lateral femoral condyle

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5
Q

rehab candidates criteria after ACL injury

A

single, cross over timed hop >80%
</= 1 episode of giving way since injury
KOS ADL and sport scale >80%
global rating scale >60%

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6
Q

for ACL injury, which criteria indicate high likelihood of receiving surgery?

A
  1. higher activity level
  2. more episodes of giving way
  3. lower KOS-ADL score
  4. lower score on IKDCSKF 2000
  5. lower score on limb symmetry index on timed 6 m hop tests
  6. lower quad strength index
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7
Q

PCL tear special tests

A

posterior drawer
posterior sag sign
valgus stress at 0 deg

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8
Q

what is the 2nd most common injury of knee?

A

MCL tear

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9
Q

T/F: an MCL tear will usually have normal ROM

A

T

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10
Q

special tests for MCL

A

valgus stress test at 20-30 deg flex

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11
Q

special tests for LCL

A

valgus stress test at 30 deg flexion

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12
Q

what structures are involved with anteromedial rotary instability?

A

MCL (superficial and deep)

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13
Q

what structures are involved with anterolateral rotary instability?

A

ACL
ITB

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14
Q

what structures are involved with posteromedial rotary instability?

A

sartorius
gracilis
semimembranosus
semitendinosus
medial gastroc
PCL

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15
Q

what structures are involved with posterolateral rotary instability?

A

LCL
popliteal tendon
lateral gastroc

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16
Q

MOI for anteromedial rotary instability

A

excessive valgus force and tibial ER
anterior sublux of medial tibial plateau

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17
Q

special test for anteromedial rotary instability

A

anterior drawer with tibial ER

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18
Q

special test for anterolateral rotary instability

A

anterior drawer with tibial IR
pivot shift (sublux near extension)

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19
Q

which instability is almost always associated with an ACL tear?

A

anterolateral rotary instability

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20
Q

MOI for anterolateral rotary instability

A

excessive valgus force with tibial IR
ACL tear
anterior sublux of lateral tibial plateau

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21
Q

special test for posteromedial rotary instability?

A

posterior drawer with slight IR

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22
Q

MOI for posteromedial rotary instability

A

force in extension and IR
valgus moment

23
Q

MOI for posterolateral rotary instability

A

laxity of PCL
tibial posterior and ER force

24
Q

special tests for posterolateral rotary instability

A

dial test/PLR test
posterior drawer with 15 deg tibial ER
reverse pivot shift (sublux at 20 deg)

25
Q

increased tibial ER ROM at 90 deg indicates what injury? 30 deg?

A

90 - PCL
30 - PL corner

26
Q

MOI for posterior lateral corner injury

A

*direct hit on proximal tibia with extended knee and varus force
- posterior force on flexed knee with tibial ER
- chronic after ACL, PCL, or LCL injury

27
Q

gait of pt with posterior lateral corner injury

A

varus thrust

28
Q

ACL reinjury incidence

A

1/3 will retear

29
Q

risk factors for ACL injury

A

narrow femoral notch
dry whether
turf
female
eccentric quad activation
greater posterior slope of tibial plateau
joint laxity

30
Q

grade A evidence for ACL diagnosis

A

medical screen
classification through eval
determine irritability
outcome measures
intervention strategies

31
Q

grade A evidence intervention strategies for ACL

A

therapeutic exercise
NM e stim (NMES)
NM re-ed

32
Q

grade B evidence intervention strategies for ACL

A

immediate mobilization
cryotherapy
supervised rehab

33
Q

grade C evidence intervention strategies for ACL

A

CPM
knee bracing
early WB

34
Q

MOI for meniscal injuries

A

closed chain TWISTING
combo valgus and hyperextension force

35
Q

factors associated with meniscal tears

A

mechanical catching or locking
forceful twist of femur (esp. medial)
joint line tenderness***
pain w/ forced knee hyperextension
pain w/ maximum passive flexion
pain or click with McMurray test
(>/= 4 –> 81%)

36
Q

where do 2/3 of articular cartilage injuries occur?

A

femoral condyles and patella

37
Q

grade B evidence for meniscus and articular cartilage injury

A

progressive knee motion
progressive WB
ther ex
NM e stim
biofeedback

38
Q

____% of people 63-94 yo have OA

39
Q

______ OA is the most common form of osteoarthritic disability in the US

40
Q

Altman’s criteria for knee OA

A

knee pain and:
- >50 yo
- palpable bony enlargement
- bony tenderness
- morning stiffness <30 mins
- no palpable warmth

41
Q

characteristics of early stage knee OA

A

osteophytes
subchondral sclerosis
subchondral cysts

42
Q

knee OA treatment key points

A

exercise
check hip
weight control
mobilize and exercise for knee ROM

43
Q

which hip motions are weak with PFPS?

A

hip abduction and ER

44
Q

intervention aims for PFPS

A

controlling hip and pelvic motion
controlling ankle/foot motion

45
Q

what mechanics affect PFPS?

A

abnormal motion of tibia and femur

46
Q

what is the hallmark of PFPS?

A

prolonged sitting (90 deg position for 30+ mins) causes knee pain

47
Q

PFPS will have pain with step ____

48
Q

PFPS pts will have what alignment during the step down test?

A

excessive hip adduction, IR, and knee valgus

49
Q

CPR for lumbopelvic manip for PFPS

A

side to side diff in hip IR >14 deg
ankle DF >16
navicular drop >3 mm
no self reported stiffness in sitting >20 mins
squatting reported as most painful activity

50
Q

patellar tendinopathy is an _____ injury

51
Q

treatments for patellar tendinopathy

A

load the tendon after healing
decreased load initially
eccentric quad
jumping mechanics

52
Q

what are the 4 stages of tendon rehab?

A

isometrics
isotonics
energy-storage exercises
progressive return to sport

53
Q

how to load patellar tendon?

A
  1. 5x45 sec isometric @ 30-60 deg flex and 70% MVIC
  2. concentric and eccentric loading
  3. pain allowed (</=3/10)
  4. plyometric training
  5. gradually return to sport-specific training

MSK LQ (18 decks)

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