LE Diagnostic Packet - MCD of Knee Flashcards
what outcome measure is specific to movement coordination deficits at the knee
anterior cruciate ligament return to sport after injury
(ACL-RSI)
main ligaments in the knee? what is their job?
MCL
PCL
ACL
LCL
– stabilization of the knee joint
what commonly causes ACL injuries
contact or noncontact
- deceleration and acceleration motions with noncontact valgus load at/near full extension
what is a classic report associated with ACL injuries
audible “pop” at time of injury
- immediate swelling and sense of knee “giving”
what typically causes an MCL injury
valgus stress applied to a flexed knee
- often can damage to ACL or lateral meniscus
what typically causes an LCL injury
less common
- direct trauma to medial aspect of the knee
what is a secondary injury commonly seen with LCL injury
common fibular nerve involvement
– will demonstrate posterolateral instability
what typically causes a PCL injury
posterior directed trauma to anterior tibia
fall onto a flexed knee with plantarflexed foot
sudden violent hyperextension
what can patellar instability lead to
subluxation or dislocation
explain patellar subluxation
typically occurs laterally
- due to patellofemoral joint dysplasia and extensor mechanism imbalance
explain patellar dislocation
complete displacement of patella out of femoral trochlea
– due to torsional stress placed on an extensor mechanism
ROM finding associated with movement coordination deficit of the knee
ROM loss due to increased joint effusion/pain
apprehension of full flexion (patellar instability)
muscle performance finding associated with movement coordination deficit of the knee
weakness of HS, Quad, and glutes
palpation finding associated with movement coordination deficit of the knee
palpable pain/swelling typically present
localized pain to tissue acutely
joint mobility finding associated with movement coordination deficit of the knee
increased jt laxity present
- direction of laxity specific to the injured structures/grade of injury
special test of the ACL
anterior drawer test at 90°
lachman’s test
special tests of the PCL
posterior drawer at 90°
sag sign
active quadriceps test
special test of MCL
valgus stress test at 30°
special tests of LCL
varus stress test at 0° and 30°
special test for patellar instability
apprehension test
Level A evidence interventions for ACL injury
therapeutic exercises
NMES
NM re-education
explain therapeutic exercise for ACL reconstruction
weight/non-weightbearing concentric and eccentric exercise
–within 4-6 wks
–2-3x per week
for 6-10 months
NMES for ACL reconstruction protocol
for 6-8 wks to augment muscle strengthening exercises
— increase quads strength and enhance short-term functional outcomes
explain neuromuscular re-education for ACL reconstruction surgery
incorporated with muscle strengthening exercise for those with knee stability and movement coordination impairments
