Ligament Injuries To The Knee Flashcards

1
Q

What kind of collagen is present in ligaments?

A

Type 1

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2
Q

What are ligaments structured to resist?

A

Tension

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3
Q

How are most ligaments packaged?

A

Into bundles

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4
Q

What will load do in elastic properties?

A

Deform to proportion of load when it is applied

Return to original shape when it is removed

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5
Q

What are viscous properties?

A

Resistance to flow of fluid

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6
Q

What type of fiber is scar tissue?

A

Type 3

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7
Q

What does moderate stress induce?

A

Organization of collagen in more parallel arrangements

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8
Q

When does peak energy absorption performance of a ligament occur?

A

Time of skeletal maturity (gradually declines after)

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9
Q

What is the relationship between the MCL and meniscus?

A

Grade 2 or 3 MCL injury usually involves meniscus too

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10
Q

What are the major functions of ligaments?

A

Stability and proprioception

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11
Q

What are the 4 major ligaments of the knee?

A

ACL

PCL

MCL

LCL

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12
Q

What ligaments have attachment to the meniscus?

A

ACL

PCL

MCL

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13
Q

What is the function of the posterior capsule?

A

Resists knee extension

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14
Q

What would a second degree ligament sprain fall under in the stress strain curve?

A

Plastic region

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15
Q

What would a first degree ligament sprain fall under in the stress strain curve?

A

Elastic region

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16
Q

What would a third degree ligament sprain fall under in the stress strain curve?

A

Failure region

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17
Q

How long does a grade 2 ligament injury take to heal?

A

4-6 weeks

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18
Q

What is a grade 1 ligament strain?

A

Pain with stress testing (no instability)

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19
Q

What is a grade 2 ligament strain?

A

Pain with stress testing (instability, firm end feel)

20
Q

What is a grade 3 ligament strain?

A

Complete tear (instability, no firm end feel) (less pain)

21
Q

What are younger children more likely to get over a ligament injury?

A

Avulsion fracture

22
Q

What are the special tests for the MCL?

A

Valgus stress test at 20-30°

23
Q

Does the valgus stress test help rule in or rule out?

A

Rule out (high sensitivity)

24
Q

What are special tests used for the LCL?

A

Palpation

Varus stress test at 20°

25
Q

What are the special tests used for the ACL?

A

Lachman’s

Anterior drawer

26
Q

Is Lachman’s good at ruling in or out?

A

Both (high sensitivity and specificity)

27
Q

Is the anterior drawer good and ruling in or out?

A

Ruling in (high specificity)

28
Q

What are special tests used for the PCL?

A

Sag sign

Posterior drawer

29
Q

Are sag sign and posterior drawer good at ruling in or out?

A

Both (high sensitivity and specificity)

30
Q

When should a decision to be made to have ACL surgery post injury?

A

6-12 months

31
Q

What do copers and non copers have in common?

A

Poor quad control

32
Q

What percentage of grade 3 PCL sprains are repaired surgically?

A

10%

33
Q

How long does a PCL take to heal with surgery?

A

18 months

34
Q

What is a quad allograft compared to a patellar autograft?

A

Larger and stronger

35
Q

What is there less of with a quad autograft?

A

Anterior knee pain and pain with kneeling

36
Q

What is a complication of getting a quad autograft?

A

More difficult to harvest and surgeons have less experience

37
Q

How should you be early on if you get a hamstring allograft?

A

Less aggressive

38
Q

What should you not do if you get a hamstring allograft?

A

No isolated hamstring strengthening until week 8

39
Q

What is at an increased risk of you get a quad autograft?

A

Patellar fracture

40
Q

What is the first goal when treating a patient who had an ACLR?

A

Knee extension as quickly as possible

41
Q

What is the most important intervention to prevent a second ACL injury?

A

Neuromuscular control

42
Q

What is the weakest time for a graft?

A

6-8 weeks

43
Q

Return to participation

A

Practice (non contact)

44
Q

Return to sport

A

Riding bench, time constraint (playing different position)

45
Q

Return to performance

A

Back in sport at a higher level than before

46
Q

When should you perform a return to sport assessment?

A

Week 8 and then gradually throughout rehab

47
Q

What is an important limb symmetry test that should be included in your return to sport assessment?

A

Hop test