Ortho Final KNEE Flashcards
What is the knee complex?
Tibiofemoral joint and Patellofemoral Joint
How many degrees of freedom is the knee?
2 and is a hinge joint
The femoral condyles articulate with ____________ condyles
Tibial
The femoral surface has 2 large condyles seperated by what?
Intercondylar Notch
The patella includes what 2 things
Base
Apex
The posterior side of the patella is covered by what?
Thick Articular Cartilage
Medial Side of Tibiofemoral Joint
more complex than lateral
What are the frontal plane stabilizers of the patellofemoral joint?
Medial Retinaculum
Lateral Retinaculum
Medial Patellofemoral Lig.
Lateral Patellofemoral Lig
Infrapatellar Ligament
*Work with a knee for dynamic stabilization of the patella
The greater the angle of flexion of the knee…..
the greater the compressive force on the patella by the quadriceps
Natural lateral pull due to Q Angle. What are the norms?
Male: 13 (12)
Female: 17 (18)
What can lead to poor patellar tracking?
Changes in alignment of bony segments
Weakness in medial knee muscles
Tightness in lateral structures
Tests for ACL
Lachman
Anterior Drawer
Pivot Shift
Tests for PCL
Posterior Drawer
Test for LCL
Varus Test
Test for MCL
Valgus Test
Tests for Meniscus
McMurray
Apley Grind Test
Bounce Home test
What test is used for Swelling
Ballottement Test
Name all the Bursa in the knee
Suprapatellar
Pre-Patellar
Superficial Infrapatellar
Deep Infrapatellar
Pes-Anserine
MCL
Iliotibial Bursa
Gastroc-Semimembranosus Bursa (Baker’s Cyst)
What are the common causes of bursitis?
Trauma
Excessive External Pressure
Excessive Friction
pain/dull ache, stiff, TTP
What is the primary treatment focus for Bursitis?
pain and inflammation
How do you restore normal patellar motion?
VMO strengthening
Stretch Lateral Structures
Align Foot/Ankle/Knee/Hip
Hip ABD strengthening
What are the common areas affected by tendonitis in the lower extremity?
Patellar Tendon
Quad Tendon
Pes Anserine
Quadriceps and Patellar Tendonitis usually result from what movement
Excessive load in jumping
Pes Anserine tendonitis is a result from what movement?
Low-load repetitions like running, swimming, biking
What muscles are stretched for pes anserine tendonitis?
Sartorius
Hamstrings
Gracilis
What muscles do you strengthen for pes anserine tendonitis?
Quads
Hip Abd
Glute Max
Ankle Invertors to improve knee alignment
**Decrease medial knee stress with valgus movement
What is Patellofemoral Pain syndrome (PFPS)
pain in and around the patella as a result of increased or abnormal mechanical forces between the patella and femur
What activities increase patellar stress?
Jump
Squat
Kneeling
Prolonged sitting with knee flexed
Stair Climbing
What factors affect Patellofemoral Pain Syndrom
Tight lateral retinaculum
Tight IT band
Increased q Angle
Weak Vastus Medialis (VMO)
Stretched Medical Retinaculum or medial Patellofemoral ligament
Tight hamstrings make quads passively insufficient so they require what?
increased quad contraction
What is chondromalacia
softening of articular cartilage in a GRADE 1 (aka runners knee)
What is exposed in a GRADE 4
full-thickness with exposure of subchondral bone
How do you restore or improve patellar tracking/patella compression?
Stretch tight lateral structures
Strengthen VMO
Control of Q Angle and Knee position
How do you control q angle and knee position?
Minimize:
foot pronation
Medial Tibial/Femoral Rotation
Hipp Adduction
Surgical:
Lateral Release
release of lateral retinaculum
may include shortening medial fibers
Surgical:
Patellar Realignment
cutting and moving of tibial tubercle to change the angle of pull
