Knee: Treatment 4 Flashcards
OA: nonsurgical
rehab focus
- maintain strength and ROM
- reduce loading of the joint
OA: nonsurgical
rehab to maintain strength and ROM = good (short/long) term benefits
short
OA: nonsurgical
ways to reduce loading of the joint
- weight loss
- aquatics
- rolling chair at work
- insoles
- bike/elliptical
- unloading braces (fit is important)
OA: nonsurgical
strongest predictor of development and progression of OA
quad weakness
OA: nonsurgical
possible benefit with these types of injections
hyaluronic acid injections
OA: nonsurgical
Hyaluronic acid injections may help with
- lubrication
- dec swelling and inflammation
OA: nonsurgical
oral glucosamine and chondroitin (research)
research does not support
OA: surgical options
- high tibial osteotomy
- femoral osteotomy
- unicompartmental knee replacement
- TKR
OA: surgical options
high tibial osteotomy for
unicompartmental medial damage
OA: surgical options
femoral osteotomy for
unicompartmental lateral damage
OA: surgical rehab
UKA/TKA is faster
UKA
OA: surgical rehab
WBAT unless
uncemented - progressed more slowly
OA: surgical rehab
ROM - focus on these ASAP
- neutral extension
- 90˚ flexion
OA: surgical rehab
quad activation
early introduction of this is best
high intensity NMES
OA: surgical rehab
these significantly influence outcomes
- pre-op ROM
- quad strength
Articular cartilage injury:
surgical options
- microfracture
- debridement
- chondroplasty
- OATS
Articular cartilage injury: purpose of surgery
penetrate vascular region of subchondral bone to facilitate growth of fibrocartilage
OATS =
osteochondral autograft transplantation
Articular cartilage injury: surgery
rehab - WB
limited WB
Articular cartilage injury:
WB limitations for debridement and chondroplasty
2-5 days
Articular cartilage injury:
WB limitations for microfracture
2-8 weeks
PFPS: typical demographic
young
physically active
PFPS: aggs
- squatting
- stairs
- prolonged sitting
- running
PFPS: risk factors
male or female
female
PFPS: risk factors
strength/flexibility
- dec quad flexibility
- dec strength
- dec explosive strength
PFPS: risk factors
patellar mobility
hypermobile
anterior knee pain ddx
- intraarticular
- patellar tendinopathy
- peripatellar bursitis
- plica syndrome
- Sinding Larsen Johansen
- Osgood Schlatter
- Hoffa’s fat pad
