L10 Knee Conditions Pt 2 Flashcards
Patellar Instability Demographics
10-16 y/o
3% of all knee injuries
more likely to redislocate the more previous dislocations you have
Majority of knee dislocations will
spontaneously reduce on their own
Acute traumatic patellar instability
equal distribution for gender
MOI is knee flexion with valgus loading or direct blow/contact
Chronic laxity patellar instability
recurrent subluxation episodes
due to multiple RF
women > men
RF for Patellar Instability
previous event
trochlear dysplasia
excessive high patella or lateral patellar tilt
neuromuscular incoordination
deficient VMO, hip ER, abductor muscle
generalize ligamentous laxity
Lateral dislocation
non-contact twisting injury with knee flexed and foot ER
osteochondral fx possible, caused by patella relocating
most common type
contracting the quads reduces the patella
Exam of acute dislocation
S/S: complaints of instability, ant knee pain, deformity, pops
Obs: hemathrosis, medial tenderness, increase in passive patellar translation, patellar apprehension
Complications of patella dislocations
bone bruise
fracture
loose body
osteochondral injuries are seen in 70% of patellar dislocations
Nonoperative methods for patellar instability, acute
first time WITHOUT intra-articular damage
NSAIDs, activity mod, PT
immobilization for 6 weeks
emphasis on strengthening in closed chain
Fear of re-dislocation can lead to
avoidance behaviors
compensatory patterns
lack of PA
Osteochondral trauma from dislocation can hasten onset of
osteoarthritis
Operative options for patellar dislocation, acute
removal of loose bodies
osteotomy for tibial tubercle transfer
lateral release
patellectomy
MPFL repair
MPFL repair indications
acute, first time dislocation with bony fragment
MOI of meniscus injury
WB with planted foot with flexed knee and rotation force
the ___ mensicus is most commonly injured
medial
