Knee Interventions Flashcards
General rehab goals
Restore function
ROM
Minimize swelling
Return to WB
Strength
Break up adhesions
From CPG: best evidence supports…
Neuromuscular re-education & E-stim: improve muscle integrity.
Exercise should initially be focused on
isometrics
ACL graft weakest at ___ weeks post-op
6
What is the purpose of bracing post-op ACL
Quads aren’t kicking it right away, buckling, risk of re-injury.
ACL: How do we determine when a pt is ready to remove brace?
SLR without extension lag (usually 4 wks)
ACL: Why is achieving full extension important?
Maximizes ability for quad recruitment.
Need it for gait!
ACL: avoid what movements early on?
Squats >60 - bc ACL most taut.
Terminal ext - bc tibia slides anterior, ACL taut.
ACL: if BPTB graft, ___ more easily recruited than ___
Hams easier than quads
T/F: if hamstring ACL graft, longer period of limited hamstring use compared to quad limitations with BPTB
TRUE
PCL: avoid what movements early on?
Squats >60
Open chain hamstring exercise
ACL: ROM goal (include time)
90-110 flex and full ext by 4-6 weeks
ACL: common problems that may occur post-op
Patellar tendonitis
Meniscal tears
Opposite knee ACL injury
Rehab brace
Allows us to set motion to whatever the limits of the protocol are
Functional brace
Provide stability
Control unwanted motion
Prophylactic brace
Used in sports
Prevent injury, decrease severity if injury occurs, allows motion requirements for sport but limits unwanted motion
Unloader brace
For OA
Unloads one compartment
Meniscectomy: rehab goals
Control swelling
ROM
Strength
Function
Meniscus repair: rehab goals & precautions
Protect the repair!
Initially: brace locked at 0 ext, slowly progress flex.
WB precautions: usually first 4wks.
Osgood-Schlatter: rehab goals
Stretch
Hold off on quad strengthening while everything is still tight
Patellar Tendinopathy: rehab treatments
Address MOI if known
Patellar tdn strap
Rest
Stretch
Friction massage
Platelet-rich plasma (re-inject platelets)
Fat Pad Syndrome: treatment options
Address inflammation
Corticosteroids
Surgical removal
Plica: rehab treatments
Modalities (ice)
Friction massage
ITB Friction Syndrome: rehab goals
ITB itself doesn’t have much flexibility.
Address biomechanics.
PFPS: treatment options
Exercise - specific parameters depend on cause/MOI.
Closed-chain good - eccentrically load quads.
Taping, bracing, foot orthoses
PFPS: taping can be used as treatment or…
to diagnose
Research suggests _____ may be beneficial for PFPS
Lumbar manipulations
