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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
increased tibial ER ROM at 90 deg indicates what injury? 30 deg?
90 - PCL 30 - PL corner
26
MOI for posterior lateral corner injury
*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
gait of pt with posterior lateral corner injury
varus thrust
28
ACL reinjury incidence
1/3 will retear
29
risk factors for ACL injury
narrow femoral notch dry whether turf female eccentric quad activation greater posterior slope of tibial plateau joint laxity
30
grade A evidence for ACL diagnosis
medical screen classification through eval determine irritability outcome measures intervention strategies
31
grade A evidence intervention strategies for ACL
therapeutic exercise NM e stim (NMES) NM re-ed
32
grade B evidence intervention strategies for ACL
immediate mobilization cryotherapy supervised rehab
33
grade C evidence intervention strategies for ACL
CPM knee bracing early WB
34
MOI for meniscal injuries
closed chain TWISTING combo valgus and hyperextension force
35
factors associated with meniscal tears
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
where do 2/3 of articular cartilage injuries occur?
femoral condyles and patella
37
grade B evidence for meniscus and articular cartilage injury
progressive knee motion progressive WB ther ex NM e stim biofeedback
38
____% of people 63-94 yo have OA
33%
39
______ OA is the most common form of osteoarthritic disability in the US
knee
40
Altman's criteria for knee OA
knee pain and: - >50 yo - palpable bony enlargement - bony tenderness - morning stiffness <30 mins - no palpable warmth
41
characteristics of early stage knee OA
osteophytes subchondral sclerosis subchondral cysts
42
knee OA treatment key points
exercise check hip weight control mobilize and exercise for knee ROM
43
which hip motions are weak with PFPS?
hip abduction and ER
44
intervention aims for PFPS
controlling hip and pelvic motion controlling ankle/foot motion
45
what mechanics affect PFPS?
abnormal motion of tibia and femur
46
what is the hallmark of PFPS?
prolonged sitting (90 deg position for 30+ mins) causes knee pain
47
PFPS will have pain with step ____
down
48
PFPS pts will have what alignment during the step down test?
excessive hip adduction, IR, and knee valgus
49
CPR for lumbopelvic manip for PFPS
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
patellar tendinopathy is an _____ injury
overuse
51
treatments for patellar tendinopathy
load the tendon after healing decreased load initially eccentric quad jumping mechanics
52
what are the 4 stages of tendon rehab?
isometrics isotonics energy-storage exercises progressive return to sport
53
how to load patellar tendon?
1. 5x45 sec isometric @ 30-60 deg flex and 70% MVIC 2. concentric and eccentric loading 3. pain allowed (

MSK LQ (18 decks)

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