MSK- Knee Flashcards
Why does the medial meniscus tear easier than lateral?
doesnt move as much during flexion
attatched to MCL, ACL, PCL and semimembranous
Why is there giving way with meniscal tears?
swelling in the knee decreases quad activation
Tibial ER -> Tibial IR->
Tibial ER -> medial meniscus
Tibial IR-> lateral meniscus
Meniscus special tests
McMurray’s
Apley’s
Thessalys
Bounce Home
Meniscal- Interventions
decrease inflammation
pain-free ROM
strengthening
What is hemarthrosis?
bleeding in the joint, causing excessive symptoms in all tests
Direction of the ACL?
BUL
Backward, up, and lateral
ACL- special tests?
anterior drawer
lachman’s test
pivot-shift
ACL interventions
decrease pain
decrease swelling
bracing
crutches (if necessary)
strengthening (CKC-> OKC)
proprioception
restore ROM
The two grafts
hamstring (gracilis and semitend)- more likely for an ACL reinjury
patellar tendon- more likely for PFPS
PCL special tests
posterior drawer
posterior sag sign
godfrey (gravity)
PCL- interventions
decrease pain
decrease swelling
bracing
strengthening
proprioception
restore ROM
MCL- special test
valgus stress test
MCL- interventions
decrease pain
decrease swelling
bracing
strengthening
proprioception
restore ROM
LCL- special test
varus stress test
LCL- interventions
decrease pain
decrease swelling
bracing
strengthening
proprioception
restore ROM
LCL most palpable position
figure 4
MCL taut in?
all fibers taut in extension
anterior fibers in flexion
posterior in mid-range
Knee OA- cardinal signs
morining stiffness (geling period)
Knee OA- interventions (conservative)
muscle strenghtneing
low impact exercises
decrease swelling
decrease pain
increase ROM
improve fxn
assistive device for ambulation
bracing if needed
weight loss
Knee OA- interventions (surgical)
aspiration
injections (hyaluronic acid- synvisc)
arthroscopic debridement
proximal tibial osteotomy (wedging)
partial or total knee replacement
What is chondromalacia patellae
degeneration of patellar articular cartilage (behind the patella pain)
PFPS- intrinsic factors
increased Q angle
muscle fascial tightness (TFL and plantarflecxion tightness)
hip muscle weakness
VMO insuffincency
Lax medial retinaculum
Q angle normal ranges
12-15 deg
15-18 deg
PFPS- special tests
clark’s sign
McConnel test
Step-up test
Eccentric step test
Special tests for intrarticular swelling
brush test
patellar tap test
PFPS interventions
temporarily reduce activity involving high or prolonged loads
bracing / taping
lateral retinaculum stretch
VMO training
Glite medius strenghthening
arch support and foot intrinsic training
treat underlying causes
Infrapatella fat pad impingement
signs and symptoms arising around 20 degress of knee flexion
fat pad impingement epidemiology
patella alta (abnormally high patella)
genu recurvatum (high extended knee when standing)
anterior pelvic tilt
inferior patellar tilt
hyperextension injury
fat pad special test
Hoffa’s test
look for camel sign
Patella dislocation- interventions (following reduction)
early
- immobilization
- decrease inflammation
- crutches until full extension
- normalize gait
- isometric and ROM exercises
later
- progress to CKE (emphasis VMO and glute med)
- patellar bracing
Patella tendinosis- interventions
manage pain
manage swelling
patellar tendon strap
avoid overloading quadriceps
progressive loading ( eccentric quads contraction)
Apohysis
bony tubercle
Apophysitis
bony tuberlce inflammation
Osgoodes interventions
manage pain
manage swelling
decrease parameteres of aggravating
patellar tendon strap
ITB syndorms- special tests
noble compression test
obers test
thomas test
ITB interventions
devrease pain
avoid aggravting activities
TFL/ITB stretches and soft tissue mobilizations
Knee birsitis- common bursas injured
pes anserine
prepatellar (housemaids knee)
superficial infrapatellar
deep infrapatellar
knee bursitis interventions
manage swelling
manage pain
avoid aggravting activities
stretching and soft tissues
Bakers cyst- signs
goose egg in the popliteal fossa
pain when knee extended and standing
Baker’s Cyst- interventions
self-limiting- heals itself
manage swelling
manage pain
avoid aggravting activiites
compression sleeve
OCD (osteochondritis dissecans)- what is it
crack in the bones and gets into the knee joint- true locking like meniscus
Myositis ossficans- what is it?
formation of bone in areas of trauma due to calcification
Myositis ossificans- contraindications
massage, passive stretching, and resistive exercises
