L10 Knee Conditions Pt 2

Question 1

Patellar Instability Demographics

Answer 1

10-16 y/o
3% of all knee injuries
more likely to redislocate the more previous dislocations you have

Question 2

Majority of knee dislocations will

Answer 2

spontaneously reduce on their own

Question 3

Acute traumatic patellar instability

Answer 3

equal distribution for gender
MOI is knee flexion with valgus loading or direct blow/contact

Question 4

Chronic laxity patellar instability

Answer 4

recurrent subluxation episodes
due to multiple RF
women > men

Question 5

RF for Patellar Instability

Answer 5

previous event
trochlear dysplasia
excessive high patella or lateral patellar tilt
neuromuscular incoordination
deficient VMO, hip ER, abductor muscle
generalize ligamentous laxity

Question 6

Lateral dislocation

Answer 6

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

Question 7

Exam of acute dislocation

Answer 7

S/S: complaints of instability, ant knee pain, deformity, pops

Obs: hemathrosis, medial tenderness, increase in passive patellar translation, patellar apprehension

Question 8

Complications of patella dislocations

Answer 8

bone bruise
fracture
loose body

osteochondral injuries are seen in 70% of patellar dislocations

Question 9

Nonoperative methods for patellar instability, acute

Answer 9

first time WITHOUT intra-articular damage

NSAIDs, activity mod, PT
immobilization for 6 weeks
emphasis on strengthening in closed chain

Question 10

Fear of re-dislocation can lead to

Answer 10

avoidance behaviors
compensatory patterns
lack of PA

Question 11

Osteochondral trauma from dislocation can hasten onset of

Answer 11

osteoarthritis

Question 12

Operative options for patellar dislocation, acute

Answer 12

removal of loose bodies
osteotomy for tibial tubercle transfer
lateral release
patellectomy
MPFL repair

Question 13

MPFL repair indications

Answer 13

acute, first time dislocation with bony fragment

Question 14

MOI of meniscus injury

Answer 14

WB with planted foot with flexed knee and rotation force

Question 15

the ___ mensicus is most commonly injured

Answer 15

medial

Question 16

How many ACL tears also involved meniscus injury?

Answer 16

> 50%

Question 17

Gold standard for diagnosis of meniscus tear

Answer 17

subjective complaints (joint line tenderness)
MRI

Question 18

PT vs Surgery for meniscus tears

Answer 18

exercise therapy shows more of a positive effect over surgery
chronic or degenerative without OA should consider therapy instead

Question 19

Knee OA is more common in

Answer 19

women
older people (>50)

Question 20

Presentation of Knee OA

Answer 20

Older (>50)
greater BMI
knee misalignment or limited knee ext
palpable crepitus

Question 21

TKA and OA

Answer 21

20% of patients with TKA do not experience long term improvements

Question 22

Poor outcome of TKA

Answer 22

lower functional scores pre op
female
patients receiving social benefits
incomplete rehab POC

Question 23

Knee OA interventions

Answer 23

mobs of hip
GLAD program
weight management
aquatic exercise