LE Diagnostic Manual - MD of Knee Flashcards
outcome measures for mobility deficits of the knee
PSFS
WOMAC
KOOS - knee injury OA outcome score
IKDC-2000 - international knee documentation committee
LEFS
how common is knee OA
most common location of OA in the body
common subjective reports of knee OA
morning stiffness
increased symptoms with prolonged standing/walking or fixed positioning
deep aching after activity
risk factors of knee OA
genetics
female sex
past trauma
advancing age
obesity
typical mechanism of meniscal tear
force rotation on a flexed knee
twisting while weight bearing
repetitive deep flexion
what are the mobility deficits of the knee
OA
meniscal tears
osteochondritis dissecans
common subjective report of meniscal tears
feeling of “giving” in affected knee
deep pain
intermittent locking, catching, clicking and/or buckling of affected knee
which meniscus is more susceptible to injury
medial meniscus
- has much more reduced mobility
what is osteochondritis dissecans
osteochondral lesion that can occur on hyaline cartilage of patella and/or femoral condyles
common subjective report of osteochondritis dissecans
pain and swelling in/around knee joint
— stabbing feeling that is exacerbated by activity
feeling of giving way/clicking/locking
stiffness and feeling of instability
ROM finding associated with mobility deficit of the knee
OA - pain at end range, flexion worse than extension
Meniscal - clicking present with ROM
OD - active/passive extension limited much more than flexion
muscle performance finding associated with mobility deficit of the knee
weakness in glutes and quads is common
– recommended to use isometric/kinetic testing
palpation finding associated with mobility deficit of the knee
OA - diffuse tenderness/deformity of tibiofemoral joint may be present
meniscal - palpable edema may be present/joint line tenderness
OD - warmth in affected knee, intermittent palpable swelling present
what is the modified stroke test for?
palpation of edema in the knee
assessment of quantity/ability of edema to be moved
joint mobility finding associated with meniscal tears in the knee
locking is often present
- reduced ability to fully flex or extend knee
joint mobility finding associated with osteochondritis dissecans in the knee
capsular and non-capsular movement restrictions can be found during assessment
severity is dependent upon possible herniation of knee joint/degree of joint irritation
special tests for meniscal tears
Thessaly test
McMurray’s test
forced hyperextension (bounce home test)
composite test
patient education for knee OA
addressing prognostic factors of BMI
early mobility plan and activity progression as tolerated
what is used to improve joint mobility in those with knee OA
tibiofemoral joint mobilization
after ROM is improved, what should be done next for those with knee OA
progressive loading to strengthen hip and knee musculature
if TKA – begin within 7 days post-op
modalities indicated for knee OA
educate patient on cryotherapy early in TKA rehab
NMES for quad strengthening
DO NOT use CPM after surgery
early rehab strategies for meniscal tears include
progressive motion
- active and passive knee motion following surgery
early to late rehabilitation strategies for meniscal tears include
progressive weight bearing
progressive return to activity
supervised rehab
therapeutic exercise
NMES / biofeedback
what therapeutic exercises are indicated ruing early-late meniscal repair rehab
supervised progressive ROM exercises
progressive strength training of knee/hip
neuromuscular training
