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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
Q

PART 6: ACL INJURY

A

PART 6: ACL INJURY

26
Q

What interventions can be used for prevention of ACL injury?

A

-Exercise-based knee injury prevention programs

27
Q

What is the primary goal of conservative and surgical intervention for ACL lesions?

A

-Return functional stability to the knee.

28
Q

What are some surgeries performed for ACL lesions?

A
  • Debridement
  • Repair (rare)
  • Reconstruction (tissue/origin)
29
Q

What is the gold standard surgical management of ACL lesions?

A

-Double-bundle Semitendinosus & Gracilis Autograft

30
Q

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.
A
  • rotational stability

- knee OA and damage to the meniscus

31
Q

What are the phases of post-op management for ACL lesions?

A
  • 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
Q

Immediate Post-op Phase (Week 1):

  • Knee A/PROM __-__ degrees.
  • Active _____ contraction.
A
  • 0-90

- Active quad contraction

33
Q

Early Post-op Phase (Week 2):

  • Knee flexion >____ degrees
  • Ambulation ________ crutch
  • Full knee ________ with ambulation
  • Knee outcome survey >___%
  • No ____________ with SLR
  • Reciprocal __________
  • __________
A
  • 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
Q

Intermediate Post-op Phase (Week 3-5):

  • Knee flexion ROM within ___ degrees of non-affected LE
  • Quad strength >___% of non-affected LE
A
  • 10 degrees

- >60%

35
Q

Late Post-op Phase (Week 6-8):

  • _____ knee ROM
  • Quad strength >___% of non-affected LE
  • ______ gait
  • Knee effusion trace or less
A
  • full knee ROM
  • > 80%
  • normal gait
36
Q

Transitional Phase (Week 9-12):

  • Maintain/improve _____ strength
  • Hop test >___% of non-affected side (week 12)
  • KOS >___%
A
  • quad strength
  • 85%
  • 70%
37
Q

What are the prognostic factors for conservative management of ACL lesion?

A
  • Age/gender
  • Occupation/sport participation level
  • Radiographic findings
  • KT-1000 arthrometric measurement
  • Knee function scores
  • Presence of additional knee injuries
38
Q

When do we want to address pain and inflammation in ACL lesions?

A

-Early

39
Q

PART 7: PATELLAR TENDINOPATHY

A

PART 7: PATELLAR TENDINOPATHY

40
Q

What are the best exercises?

A

-Eccentrics

41
Q

PART 8: TENDON RUPTURE (patellar/quad)

A

PART 8: TENDON RUPTURE (patellar/quad)

42
Q

Describe the phases of repair with patellar/quad tendon rupture.

A
  • <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
Q

PART 8: PATELLAR FRACTURE (NON-SURGICAL)

A

PART 8: PATELLAR FRACTURE (NON-SURGICAL)

44
Q

Acute:

A
  • 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
Q

6-12 weeks

A
  • Pain-free ranges

- Progress WB exercises

S6- MSK 2 (21 decks)

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