Knee: Treatment 1

Question 1

Primary goals for general knee rehab:

Answer 1

• avoid arthrofibrosis
• restore knee extension ASAP
• increase quad strength

Question 2

Primary goals for general knee rehab:

pain and swelling are signs of

Answer 2

progressing too quickly

Question 3

ACL tears: females (#)x more likely to tear ACL

Answer 3

4-8x more likely

Question 4

ACL tears: occurs with these types of movements

Answer 4

pivoting/cutting

typically noncontact

Question 5

ACL tears: At 1 year post-surgery, only (%) of pts attempted some type of athletics

Answer 5

67%

Question 6

ACL tears: prevention programs

(%) reduction in risk with strengthening and proximal control exercises

Answer 6

> 65%

Question 7

ACL tears: nonsurgical

goals

Answer 7

• restore joint mobility
• increase quad strength/endurance
• agility training
• protective bracing
• activity modification

Question 8

ACL tears: “copers”
nonsurgical

To be considered for screening, must have

Answer 8

• no knee effusion
• full ROM
• isolated ACL tear
• > 70% involved/uninvolved quad ratio
• hop on injured leg without pain

Question 9

ACL tears: nonsurgical

rehab candidate if score (%) on Noyes hop tests

Answer 9

80% involved/uninvolved

Question 10

ACL tears: nonsurgical

rehab candidate if score (%) on KOS

Answer 10

> 80%

Question 11

ACL tears: nonsurgical

rehab candidate if score (%) on global rating of knee function

Answer 11

> 60%

Question 12

ACL tears: nonsurgical

rehab candidate if (#) of episodes of giving way

Answer 12

≤ 1 episode

Question 13

ACL tears: surgical
graft options (surgeon dictated)

Answer 13

• bone - patella tendon - bone
• hamstring graft
• various allografts

Question 14

ACL tears: surgical

BTB - increased incidence of (pain)

Answer 14

anterior knee pain

Question 15

ACL tears: surgical

BTB - potential for increased risk of (patella)

Answer 15

patellar fx

Question 16

ACL tears: surgical

hamstring (muscles used)

Answer 16

semitendinosus

gracilis

Question 17

ACL tears: surgical

hamstring - increased risk of this during rehab

Answer 17

hamstring strain

Question 18

ACL tears: surgical

allografts - eliminates problems with

Answer 18

harvest sites

Question 19

ACL tears: surgical

(double/single) bundle to more exactly match pre-injury anatomy

Answer 19

double bundle

Question 20

ACL tears: surgical

ROM after reconstruction can be affected by

Answer 20

• surgical technique

- graft placement

Question 21

ACL tears: surgical

WB

Answer 21

immediate WBAT

Question 22

ACL tears: surgical

ROM

Answer 22

• focus on early full PROM extension

- pre-op “calm knee” has better ROM outcomes

Question 23

ACL tears: surgical

most stress on ACL graft in this position

Answer 23

last 30˚ of NWB knee ext

Question 24

ACL tears: surgical

Both WB and NWB exercises should be incorporated and you should also incorporate this modality

Answer 24

NMES

Question 25

ACL tears: surgical
concomitant injuries

What should you use to dictate rehab guidelines and progression?

Answer 25

use the most limiting factor

Question 26

ACL tears: surgical
concomitant pathologies

These types of injuries supersede ACL rehab guidelines

Answer 26

meniscal

cartilage

Question 27

ACL tears: surgical
concomitant pathologies

Chondral damage or chondroplasty: WB

Answer 27

WB restrictions x 4 weeks

Question 28

ACL tears: surgical
concomitant pathologies

MCL injury and ACL-R

Answer 28

ACL-R provides stability for even a grade 3 MCL sprain to heal

Question 29

ACL tears: surgical
concomitant pathologies

PCL injury

Answer 29

PCL guidelines supersede ACL

Question 30

ACL tears: surgical
concomitant pathologies

ACL revision: WB

Answer 30

PWB x 2 weeks

Question 31

ACL tears: surgical
concomitant pathologies

ACL revision - return to run

Answer 31

delayed