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clinical practice guidelines > knee ligaments > Flashcards

knee ligaments Flashcards

1
Q

what is the ratio of non contact to contact ACL injuries

A

70% non

30% contact

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2
Q

what percentage of athlete knee injuries does ACL injuries make up

A

20% over 10 years study

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3
Q

What is the ratio of male to female ACL injuries

A

2.4-9.7x more likely for females

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4
Q

How do ACL injuires impact risk of meniscus injury

A

ACL deficient knees will have 40, 60 80% at years 1,2,3 post ACL injury

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5
Q

what are the most common multi ligament injuries of the knee

A

MCL adn ACL

PLC with ACL or PCL

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6
Q

describe the incidence of ACL injury as it relates to valgus laxity

A

20% ACL injuires with no valgus laxity
53% ACL injury with laxity at 30 degree
78% ACL injury with laxity at 0 degrees

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7
Q

what are the different parts of the ACL

A

anteromedial and posterolateral bands

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8
Q

What motion does the ACL restrain

A

anterior translation of the tibia

IR particularly when in extension

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9
Q

what part of the ACL is usally hurt

A

mid substance

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10
Q

what are the different parts of the PCL

A

anterolateral and posteromedial

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11
Q

what motion does the PCL restrain

A

posterior glide and ER

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12
Q

what are the most common mechanism of injury for PCL

A
  1. dashboard
  2. fall on a flexed knee with foot plantar flexed
  3. violent hyperextension
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13
Q

how layers does the MCL have

A
  1. superficial
  2. deep
  3. posterior oblique ligament
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14
Q

what makes up the PLC

A
  1. lateral head of gastroc
  2. poplitieus tendon
  3. LCL
  4. arcuate ligament-fabellafibular ligement
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15
Q

what percentage of people return to normal activity follow non-operative ACL injury

A

42% if avoid high risk activity

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16
Q

what is the greatest predictor of post operative ROM loss after ACL surgery

A

Presurgical ROM loss

17
Q

Describe the strength and function deficits between copers and post ACL people

A

they are about the same

18
Q

what are the risk factors for ACL injuries

A
  1. shoe surface interation for hight traction
  2. increased BMI
  3. narrow femoral notch
  4. increased joint laxity
  5. stage of menstrual cycle (late follicular, preovulatory phases both identified)
19
Q

What is the prescreening criteria for identifying potential ACL deficient copers

A
  1. level 1 or 2 athlete or worker
  2. no concomitant injuries
  3. none to trace knee effusion
  4. full knee range of motion
  5. normal gait
  6. 70% quad strength
  7. hop up and down on leg without pain
20
Q

what is the screening exam for identifying potential ACL deficient copers

A
  1. number of giving away episodes less than or equal to 1
  2. single limb 6m timed hop test 80% of uninvolved side
  3. KOS-ADL score greater than or equal t 80%
  4. glodal rating of precieved function greater than or equal to 60%
21
Q

diagnostic criteria for ACL injury

A
  1. deceleration mechanism of injury
  2. pop at time of injury
  3. hemathrosis 0-2 hours post injury
  4. h/o giving away
  5. loss of knee extension
  6. lachman
  7. pivot shift
  8. 6m time hop test less than 80%
  9. MVC of quad less that 80%
22
Q

diagnostic criteria for knee instability classification

A
  1. passive instability testing
  2. joint effusion
  3. aberrant movement
  4. joint pain
23
Q

what is the MDC for KOS-ADLS, KOOS, IKDC 2000

A
  1. Knee injury and osteoarthritis outcome score - pain domain 13, sport domain 22, quality of daily life 15
  2. international knee documentation committee 11.5
  3. knee outcome survey ADL 8.8
24
Q

what is the pivot shift test

A

The patient lies supine with legs relaxed. The examiner grasps the heel of the involved leg with examiners opposite hand placed laterally on the proximal tibia just distal to the knee. The examiner then applies a valgus stress and an axial load while internally rotating the tibia as the knee is moved into flexion from a fully extended position. [6] A positive test is indicated by subluxation of the tibia while the femur rotates externally followed by a reduction of the tibia at 30-40 degrees of flexion.

25
Q

how does bracing impact recovering following acute ACL injury

A

short term improvements in the perception of stability, but by 6-12 weeks its benefit is gone. Long term questionable benefit. Overall it appears beneficial

26
Q

what works better open or closed chain exercises for knee instability rehab

A

they both help and both are recommended

clinical practice guidelines (10 decks)

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