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S6- MSK 2 > Week 5- Knee Interventions > Flashcards

Week 5- Knee Interventions Flashcards

1
Q

PART 1: PFPS

A

PART 1: PFPS

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2
Q

What muscle strengthening is highly indicated for PFPS?

A

-Hip ER and ABD

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3
Q

“________” for hypomobility/coordination vs “__________” for compressive syndromes

A
  • “Stability”

- “Mobility”

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4
Q

What 2 intervention strategies are not promising with PFPS?

A
  • Taping

- Bracing

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5
Q

Taping is likely to have _________/_________ effect, but is unlikely to have __________ _________.

A
  • neuromuscular/proprioceptive

- biomechanical correction

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6
Q

What is a common surgical intervention used for PFP?

A

-Lateral release and debridement (lateral retinaculum)

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7
Q

What are the 4 subcategories of individuals with PFP and what interventions can be used for each?

A

PFP Overuse/overload

  • Taping (B)
  • Activity modification/relative rest (F)

PFP With Movement Coordination Deficits
-Gait and movement retraining (C)

PFP With Muscle Performance Deficits

  • Hip/gluteal muscle strengthening (A)
  • Quad muscle strengthening (A)

PFP with Mobility Deficits

  • Hypermobility
    • Foot Orthosis (A)
    • Taping (B)
  • Hypomobility
    • Patellar retinaculum/STM (F)
    • Muscle stretching (F)
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8
Q

PART 2: ARTICULAR CARTILAGE DEFECTS

A

PART 2: ARTICULAR CARTILAGE DEFECTS

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9
Q

What are (3) common surgical interventions?

A
  • Arthroscopic Lavage and Debridement
  • Microfracture
  • Grafts/Chondrocyte Implantation
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10
Q

Explain the recovery process of Arthroscopic Lavage and Debridement.

A
  • Full extension ROM by week 1

- Full flexion ROM by week 3

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11
Q

Explain the recovery process of Microfracture.

A
  • Full extension ROM by week 1
  • Full flexion ROM by week 3, progress WB over weeks 6-12
  • Avoid loading at lesion site until 6-12 weeks
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12
Q

Explain the recovery process of Grafts/Chondrocyte Implantation.

A
  • Early PROM & AAROM
  • Full extension ROM by week 1
  • Full flexion ROM by week 6
  • CKC exercises once WBAT
  • Full WB week 6
  • Progressive loading 6-12 weeks
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13
Q

PART 3: OA

A

PART 3: OA

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14
Q

What 7 physical, psychosocial, and mind-body approaches are strongly recommended?

A
  • Exercise
  • Self-Efficacy and Management Programs
  • Weight Loss
  • Tai Chi
  • Cane
  • 1st CMC Orthosis
  • TF Knee Brace
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15
Q

What 3 pharmacological approaches are strongly recommended?

A
  • Oral NSAIDs
  • Topical NSAIDs
  • I-A Steroids
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16
Q

What physical, psychosocial, and mind-body approach is strongly recommended against for the knee and hip?

A

-TENS

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17
Q

OA:

  • What does pt education focus on?
  • Manual Therapy
  • LE Strengthening/Endurance
  • Diet/Weight Loss
  • Walking/Gait Training
  • Pain Control Modalities
A

Pt education focuses on patient empowerment and progression to independence and activity modification.

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18
Q

PART 4: ARTHROFIBROSIS

A

PART 4: ARTHROFIBROSIS

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19
Q

What is recommended in the ACUTE stages of arthrfibrosis?

A

-Self-management, ROM/mobility exercises, stretches, pain/inflammation control interventions, muscle performance as tolerated

20
Q

What is recommended in the CHRONIC stages of arthrofibrosis?

A

-Aggressive joint mobs, stretching, strengthening, static stretching devices (creep)

21
Q

What are some surgical interventions for arthrofibrosis?

A
  • MUA

- Arthroscopic capsular release

22
Q

PART 5: MENISCUS LESION

A

PART 5: MENISCUS LESION

23
Q

Meniscectomy post-op management.

A
  • Early ROM
  • Quicker WB exercises, strengthening exercises
  • Progress to exercise based on activity limitations
24
Q

Meniscus Repair post-op management.

A
  • Greater protection phase (~6 weeks)
  • 6-10 weeks: Gradually increase loading on involved tissues, address ROM
  • > 10 weeks: Progress to exercises based on activity limitations
25
PART 6: ACL INJURY
PART 6: ACL INJURY
26
What interventions can be used for prevention of ACL injury?
-Exercise-based knee injury prevention programs
27
What is the primary goal of conservative and surgical intervention for ACL lesions?
-Return functional stability to the knee.
28
What are some surgeries performed for ACL lesions?
- Debridement - Repair (rare) - Reconstruction (tissue/origin)
29
What is the gold standard surgical management of ACL lesions?
-Double-bundle Semitendinosus & Gracilis Autograft
30
Double-bundle Semitendinosus & Gracilis Autograft: - Improves _________ stability. - Decreases likelihood of revision, development of knee ___, and damage to the _________. - Improved function, satisfaction, and QOL as per patient self-report.
- rotational stability | - knee OA and damage to the meniscus
31
What are the phases of post-op management for ACL lesions?
- Immediate Post-op Phase (week 1) - Early Post-op Phase (week 2) - Intermediate Post-op Phase (weeks 3-5) - Late Post-op Phase (weeks 6-8) - Transitional Phase (weeks 9-12) - Follow-up Testing (4, 5, 6, 12 months)
32
Immediate Post-op Phase (Week 1): - Knee A/PROM __-__ degrees. - Active _____ contraction.
- 0-90 | - Active quad contraction
33
Early Post-op Phase (Week 2): - Knee flexion >____ degrees - Ambulation ________ crutch - Full knee ________ with ambulation - Knee outcome survey >___% - No ____________ with SLR - Reciprocal __________ - __________
- Knee flexion > 110 deg - Ambulation without crutch - Full knee extension with ambulation - Knee outcome survey (ADL subscale) ->65% - No extension lag with SLR - Reciprocal stair climbing - Cycling
34
Intermediate Post-op Phase (Week 3-5): - Knee flexion ROM within ___ degrees of non-affected LE - Quad strength >___% of non-affected LE
- 10 degrees | - >60%
35
Late Post-op Phase (Week 6-8): - _____ knee ROM - Quad strength >___% of non-affected LE - ______ gait - Knee effusion trace or less
- full knee ROM - >80% - normal gait
36
Transitional Phase (Week 9-12): - Maintain/improve _____ strength - Hop test >___% of non-affected side (week 12) - KOS >___%
- quad strength - 85% - 70%
37
What are the prognostic factors for conservative management of ACL lesion?
- Age/gender - Occupation/sport participation level - Radiographic findings - KT-1000 arthrometric measurement - Knee function scores - Presence of additional knee injuries
38
When do we want to address pain and inflammation in ACL lesions?
-Early
39
PART 7: PATELLAR TENDINOPATHY
PART 7: PATELLAR TENDINOPATHY
40
What are the best exercises?
-Eccentrics
41
PART 8: TENDON RUPTURE (patellar/quad)
PART 8: TENDON RUPTURE (patellar/quad)
42
Describe the phases of repair with patellar/quad tendon rupture.
- <3 weeks: protection, pain/inflammatory management - 3-6 weeks: light loading (resistance free cycle) - 7-12 weeks: progression of loading (full WB - 9-12 weeks: single leg CKC exercises, increase tensile loading
43
PART 8: PATELLAR FRACTURE (NON-SURGICAL)
PART 8: PATELLAR FRACTURE (NON-SURGICAL)
44
Acute:
- WBAT with AD & locked hinge brace initially - Coordination/ activation exercises for knee, muscle performance of hip - Stretching/ mobility/ modified CKC exercises at ~3-4 weeks - Patellofemoral mobs
45
6-12 weeks
- Pain-free ranges | - Progress WB exercises

S6- MSK 2 (21 decks)

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