Knee P! and Mobility Impairments

Question 1

What type of collagen are the Meniscus made of?

Answer 1

Type 1 and 2

Question 2

With Meniscus Injuries, What is the MOI?

Answer 2

Traumatic: Weight bearing with rotation - twisting injury
- Soccer, Rugby
-Audible pop or click at time of injury
-Tearing sensation

Degenerative: Repetitive flexion with loading
- Work related kneeling or squatting
- Climbing more than 30 flights of stairs per day

Question 3

Pt. with Meniscus injuries, what would we find in the Subjective Hx?

Answer 3

• Delayed effusion (6-24 hrs post injury)

Chief Complaint
- Catching or clicking of the knee with movement; Doesn’t matter if P! is involved

Question 4

What are the Agg/Ease with Meniscus injuries?

Answer 4

Agg:
- P! with end range knee flexion
- P! with knee hyperextension
- P! with knee rotation/pivoting
- Swelling and stiffness in the acute stages of the injury

Ease
- Rest

Question 5

What may we find in the Physical Examination with Meniscus Injuries?

Palpation for condition; AROM; Palpation for tenderness

Answer 5

Palpation for Condition
- (+) Modified stroke test for effusion

AROM
- P! with maximum knee flexion
- P! with forced hyperextension

Palpation for Tenderness
- Joint line tenderness

Question 6

With Meniscus injuries, what Special Test would you expect to find to be (+)?

Answer 6

Meniscal Lesion Test
- (+) McMurray test with pain or audible click
- (+) Thessaly test at 20° knee flexion with pain, sense of locking or catching (This is often the go-to)
- (+) Apley’s Compression Test

Question 7

With Meniscus Injuries, during the Physical Examination, what Physical Performance Measure can we do?

Answer 7

Activity Limitations
- 30 sec chair-stand Test
- Stair-climb Test
- Timed Up and Go Test
- 6 min Walk Tests

Return to Activity or Sports
- Single Leg Hop Test

We won’t use these in the Acute or Subacute Stage of Healing

Question 8

What are the Clinical Findings for Meniscus Injuries?

Answer 8

• Twisting Injury
• Tearing sensation at time of injury
• Delayed Effusion (6-24 hrs post-injury)
• Hx of catching or locking
• P! with forced hyperextension
• Joint Line Tenderness
• P! with maximum passive knee flexion
• P! or audible click with McMurray’s Test
• P! with Thessaly’s Test at 20° knee flexion

Question 9

What is the Prognosis for Meniscus Injuries?

Answer 9

• Dependent on type and severity of meniscal tear
• Joint mobility
• LE strength
• Goals and level of function

Question 10

What are the Clinical Findings during the Physical Examination for Articular Cartilage Injuries?

Answer 10

• Acute Trauma with hemarthosis (0-2 hrs)
• Associated with Osteochondral Fx
• Insidious onset aggravated by repetitive impact
• Intermittent pain and swelling
• Hx of “catching” or “locking”
• Join line tenderness

Question 11

With Mobility Impairments, what are the Interventions you should do in the Acute Stage for Non-surgical patients?

Answer 11

• Pain and Sx modulation - education
• Progressive knee ROM
• Progressive weight bearing
• Progressive return to activity
• Progressive strength training to knee and hip muscles
• Neuromuscular electrical stimulation

Question 12

With Mobility Impairments, what are the Interventions you should do in the Subacute Stage for Non-surgical patients?

Answer 12

• Progressive knee ROM
• Progressive weight bearing
• Progressive return to activity
• Progressive strength training to knee and hip muscles
• Neuromuscular electrical stimulation

Question 13

With Mobility Impairments, what are the Interventions you should do in the Chronic Stage for Non-surgical patients?

Answer 13

• Progressive knee ROM
• Progressive return to activity
• Progressive strength training to knee and hip muscles
• Neuromuscular electrical stimulation
• Proprioceptive training