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LL Ox > Q4: Knee Orthoses > Flashcards

Q4: Knee Orthoses Flashcards

1
Q

Primary Uses

KOs

A
  • Coronal Issues
  • Arthritis
  • Hyperextension

Suspension is a primary issue

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2
Q

Tibial Plateau

Functional Anatomy of the Knee

A

Lateral aspect is smaller and convex
Medial aspect is larger and concave

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3
Q

Menisci

Functional Anatomy of the Knee

A

Create an increase in congruence between tibia and femur

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4
Q

Menisci

Relevant Characteristics

A
  • Viscoelastic - shock attenuation
  • Made of fibrocartilage
  • Richly innervated
  • Center is avascular
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5
Q

Femoral Condyles

Functional Anatomy of the Knee

A

Asymmetrical
* Lateral - wider but shorter
* Medial - thinner but longer

Lateral/Medial divided by femoral trochlea

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6
Q

ACL/PCL

Functional Anatomy of the Knee

A

rise from the intercondylar notch

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7
Q

Facets of the Femur

Functional Anatomy of the Knee

A
  • Lateral - Concave and largest
  • Medial - Convex
  • Odd - only articulates at the end range of knee flexion
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8
Q

Patellofemoral Joint Syndrome

Functional Anatomy of the Knee

A
  • pain is common in the athletic population
  • females more likely to develop
  • Managed conservatively (unless no improvement after 6 months - then Sx)
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9
Q

ACL

Primary Roles of Ligaments

A

Resist anterior displacement of tibia relative to femur

Secondary - resist varus when extended

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10
Q

PCL

Primary Roles of Ligaments

A

Resist posterior displacement of the tibia relative to the femur

Secondary - Resists varus when extended

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11
Q

LCL

Primary Roles of Ligaments

A

Resists varus when knee is 30 degrees flexed

Secondary - resists ext. rotation below 50 degrees of flexion

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12
Q

MCL

Primary Roles of Ligaments

A

Resists valgus angulation

Secondary - Limits rotation with help of ACL

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13
Q

MCL vs. LCL

Biomechanics of the Knee

A
  • MCL has more stretch than the LCL
  • MCL attaches to med/meniscus (LCL does not)
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14
Q

Stability of the Knee

Biomechanics of the Knee

A

13 muscles assist to knee stabilization

Meniscis also assist by increasing SA; minimal perfusion

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15
Q

Axis of Rotation

Knee Joint

A

Polycentric in nature
* Follows a J-shaped path
* Tibia rolls and glides on femur
* Flexion initiated by int. rotation of tibia

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16
Q

Screw Home Mechanism

A

Locking - medial tibial condyle moves anterior (ER)
Unlocking - medial tibial condyle moves posteriorly (IR)

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17
Q

Patellofemoral Syndrome

Conservative Management

A
  • PT - strengthening
  • Ox - FOs; 1 study shows Bauerfiend Genutrain (KO sleeve) helps
  • Taping - not as much evidence
18
Q

Prophylactic KOs

Ox Design

A

Prevent Injury
* inhibit coronal motion
* can have one or two sidebars (single axis)

19
Q

Post-Op KOs

Ox Design

A

Treat acute injury
* prevent excessive loads on impaired ligament
* allow early return to activity
* longer lever arms

20
Q

Functional KOs

Ox Design

A

Return to ADLs/Athletics
* bilateral sidebars
* polycentric joints
* inhibit ant. migration of tibia on femur (protect ACL)

21
Q

Limitations of KOs

Ox Design

A
  • Migration distally - suspension issues
  • Shorter lever arms than KAFOs
  • Only crosses the knee (no transverse motion control)

Injuries to other athletes can occur too

22
Q

“Unhappy Triad”

Knee Injuries

A

ACL, MCL, and medial Meniscus

Sx is almost always indicated

AKA: O’Donoghue’s Triad

23
Q

ACL

Knee Injuries

A

Noncontact (70%)
Contact (30%)

50/50 if Sx is needed

ACL comprised of
fibrocartilage; inability to heal

24
Q

PCL

Knee Injuries

A

MOI - forced HE from direct blow

50% of time correlated with other ligament injuries

25
Q

MCL

Knee Injuries

A

MOI - Valgus stress on flexed knee

Commonly injured with other ligaments (ACL usually)

Most common ligament injury in knee

26
Q

LCL

Knee Injuries

A

MOI - direct blow resulting in excessive varus

Isolated cases are very rare

27
Q

MCL Injury Treatment

Grade I/II Sprains

A

Compressive knee sleeve OR adjustable ROM KO

28
Q

PCL Injury Treatment

Grade I/II Sprains

A

Weight bearing as tolerated; KO set in terminal extension

29
Q

LCL Injury Treatment

Grade I/II Sprains

A

KO locked in terminal extension

30
Q

ACL Injury Treatment

Grade I/II Sprains

A

Adjustable ROM KO

31
Q

ACL Injury Treatment

Grade III Sprains

A

Reconstruction for more active individuals

Less active peoples can return to preinjury levels with PT and Ox

32
Q

Adjunct Therapies

Grade I/II Sprains

A
  • PT - return to activies when 80% strength and ROM returns
  • NSAIDs
33
Q

PCL Injury Treatment

Grade III Sprains

A

Conservative Management; Sx only if CM does not work

Fibroblast allow for potential healing; Ox for 2-4 weeks

34
Q

MCL Injury Treatment

Grade III Sprains

A

Conservative Management for isolated injuries

KO set in 30 degrees of flexion with PT

35
Q

MCL Injury Treatment

Grade III Sprains

A

Conservative Management for isolated injuries

KO set in 30 degrees of flexion with PT

36
Q

LCL Injury Treatment

Grade III Sprains

A

Reconstruction typically indicated

37
Q

Efficacy of KOs

A
  • Prophylactic - favorable outcome but increased fatigue
  • Rehabilitative - Ox are a primary reason for reduced Sx management
  • Functional - without a brace, Sx outcomes not favorable
38
Q

“Does bracing patients that underwent ligament
reconstruction decrease the likelihood of future re-
injury?”

A

Some of the strong studies say “NO”

39
Q

Medial Compartment OA

A

Most common location in knee

Occurs with varus when medial compartment bears more than 70% of axial load

40
Q

Lateral Compartment OA

A

Occurs with valgus when lateral compartment bears close to 50% of axial load

More common for individuals with RA

41
Q

Knee Adduction Moment

A

GRF passes medial to the knee center creating sudden adduction; OA of medial compartment often seen

42
Q

OA - Coronal Plane Alignment

KO Design

A

LoadShifter Mechanism
* The patented LoadShifter technology allows tool-less
adjustability via the innovative SnapLock allowing the
practitioner to easily accommodate the patient’s
anatomy or the degree of unloading quickly and easily.

LL Ox (24 decks)

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